Title: Role of Prophylactic Antibiotics to Prevent the Surgical Site Infections - A Study in A Tertiary Care Hospitals
Authors: Ilangovan Muthu Karuppaiah, Raj Kumar Krishnasamy
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.149
Abstract
Introduction: Surgical site infections are the third most common nosocomial infection, which constitute 38% of surgical infections. So, the selection of an appropriate antimicrobial agent depends on the identification of the most likely pathogens that are associated with a specific surgical procedure. The administration of antibiotic prophylaxis is considered to be optimal if it is given between 30 and 60 min before skin incision.
This study was performed to evaluate the use of perioperative prophylactic antibiotics in clean surgeries
Materials and Methods: The objective of the study was to compare the frequencies of patients developing postoperative wound infection in two groups of patients (study group and control group) undergoing clean elective general surgery operations. Patients in study group were given perioperative prophylactic antibiotics while patients in control group were not given perioperative prophylactic antibiotics.
It was an experimental prospective study. The study was conducted in general surgical ward in our unit in our hospital from June 2011 to June 2012. Only those patients undergoing clean elective general surgery operations were included.
Observation and Results: Out of 50 patients in study group, 26 patients underwent hernia surgery, 12 patients underwent neck surgeries, 7 patients underwent breast surgeries and remaining 5 patients underwent scrotal surgeries. Out of 50 patients in control group, 25 patients underwent hernia surgery, 11 patients underwent neck surgeries, 8 patients underwent breast surgeries and remaining 6 patients underwent scrotal surgeries.
Regarding age distribution, in study group, 18 patients were of age <40 years, 8 patients were >60 years and the remaining were between the age group of 40-60 years. In control group, 20 patients were of age <40 years, 3 patients were >60 years and the remaining 27 patients were between the age group of 40-60 years.
Regarding sex distribution of patients, 37 numbers of patients in study group were male and the remaining 13 were female in study group. In control group, 34 were male and 16 were female patients.
None of the patients either in study or control group developed organ or space infection. Patients developed only incisional surgical site infection which was either superficial or deep seated (redness, erythema, hematoma, purulent discharge). And the isolates from purulent discharge were mostly staphylococcus aureus (2 in study group and 3 in control group). One patient in each group developed Escherichia coli.
Conclusion: we come to a conclusion that for a clean an uncontaminated surgery, the use of antibiotics prophylactically does cause a significant reduction in the rate of surgical site infection Also literature, it is not established that prophylactic antibiotic for surgeries in general surgery reduce the infection rate as in contaminated and contaminated surgeries where its role is extension studied and its reduction in rate of surgical site infection is established.
Thus to conclude, according to this study performed prophylactic antibiotics, unless warranted, has no significant role clean elective surgeries.
Key Words: Infection, Prophylaxsis, Antibodies.
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