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A comparative study of single-dose preoperative antibiotic prophylaxis versus routine long-term postoperative prophylaxis in elective general surgical cases

Alok Ranjan, Richa Singh, Pramod Chandra Naik.


Abstract

Background: Surgical site infection (SSI) is a major contributor to increased mortality and health-care cost globally, which can be reduced by appropriate antibiotic prophylactic use. The proper duration of antimicrobial use for the prevention of postoperative surgical infection has been a subject of controversy. No data currently exist about comparative study of single-dose preoperative antibiotic prophylaxis versus routine long-term postoperative prophylaxis in elective general surgical cases in India. We, therefore, examined risk factors, use, and efficacy of single-dose prophylactic antibiotic for SSI among patients in elective general surgical cases.

Objective: To study the effect of antimicrobial prophylaxis to know its effect on reducing postoperative wound infection.

Materials and Methods: This study is a randomized prospective and comparative study of a single-dose cefotaxime sodium Intra-Venous (I.V.) 1 g (40 mg/kg Body Weight (B.W.)) (versus long-term (5 days) postoperative in elective general surgical cases. A total of 200 patients were included in this study and were divided into Group A and Group B. Group A contains patients with 1 g of cefotaxime sodium intravenously, that is, single dose was given 1 h before induction of anesthesia and Group B contains patients who were given first dose at 1 h before induction of anesthesia, and subsequent doses were given at an interval of 12 h after surgery for 5 days, that is, multiple dose.

Result: The rate of wound infection in Group A was 10% and Group B was 9%. There was no statistical significance. Staphylococcus aureus was the most common organism causing wound infections.

Conclusion: In conclusion, single preoperative dose of cefotaxime sodium is cost-effective, and is as effective as multipledose prophylaxis, and a reliable method of prophylaxis in elective general surgical cases.

Key words: Antibiotic, preoperative, postoperative, single dose, wound infections






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