This tertiary care hospital based prospective study was performed to compare the effect of single dose prophylactic versus conventional antibiotic therapy in clean surgical cases operated in SSIMS&RC, Davangere. A total of 100 cases were studied, male patients were more compared to females with ratio of 3:2, with mean age of 42.7 years, all clean surgical cases were operated, with highest being inguinal hernia 31%. In this study 6% of cases in group-II and 2% case in group-I had postoperative infection, with most common organism isolated being staphylococcus aureus. This study highlights the judicious use of prophylactic antibiotics in order to prevent emergence of antibiotic resistance and to reduce prolonged hospital stay and cost incurred due to antibiotics.

Keywords: Antibiotic prophylaxis, antibiotic utilisation, clean surgical cases, cost-effective

1. Magill, S.S., et al., "Prevalence of healthcare-associated infections in acute care hospitals in Jacksonville, Florida". Infection Control Hospital Epidemiology, 33(3): (2012): 283-91.
2. Magill, S.S., et al., "Multistate point-prevalence survey of health care-associated infections". New England Journal of Medicine, 370(13): (2014): 1198-1208.
3. Mu, Y., et al., "Improving risk-adjusted measures of surgical site infection for the national healthcare safety network". Infection Control Hospital Epidemiology, 32(10): (2011): 970-86.
4. CDC National and State Healthcare-Associated Infections Progress Report, published March 2016, available from: cdc.gov/hai/surveillance/progress-report/index.html
5. Astagneau P, Rioux C, Golliot F, et al. Morbidity and mortality associated with surgical site infections: results from the 1997–1999 INCISO surveillance. Journal of Hospital Infection. 2001;48:267–74
6. Coello R, Charlett A, Wilson J, et al. Adverse impact of surgical site infections in English hospitals. Journal of Hospital Infection. 2005;60:93–103.
7. Plowman R, Graves N, Griffin MA, et al. The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. Journal of Hospital Infection. 2001;47:198–209.
8. Bernard HR, Cole WR. The prophylaxis of surgical infection, the effect of prophylactic antimicrobial drugs on the incidence of infection following potent-ially contaminated operation. Surgery 1964;56:151-7.
9. Kachroo S, Dao T, Zabaneh F, Reiter M, LaRocco MT, Gentry LO, Garey KW. Infectious Diseases: Tolerance of Vancomycin for Surgical Prophylaxis in Patients Undergoing Cardiac Surgery and Incidence of Vancomycin-Resistant Enterococcus Colonization. Annals of Pharmacotherapy. 2006 Mar;40(3):381-5.
10. Wagenlehner F, Stöwer-Hoffmann J, Schneider-Brachert W, Naber KG, Lehn N. Influence of a prophylactic single dose of ciprofloxacin on the level of resistance of Escherichia coli to fluoroquinolones in urology. International journal of antimicrobial agents. 2000 Jul 1;15(3): 207-11.
11. Martin C. Antimicrobial prophylaxis in surgery: general concepts and clinical guidelines. Infection Control & Hospital Epidemiology. 1994 Jul;15(7):463-71.
12. Chambers HF. Betalactam antibiotics and other antibiotics of cell wall synthesis. In: Katzung BG, editor. Basic of Clinical Pharmacology. 8th ed. New York: Lange Medical Books, McGraw-Hill; 2001. p. 762.
13. Woods RK, Dellinger EP. Current guidelines for antibiotic prophylaxis of surgical wounds. Am Fam Physician 1998;57:2731-40.
14. Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. New England Journal of Medicine. 1992 Jan 30;326(5):281-6.
15. Fernandez Arjona M, Herruzo Cabrera R, Gomez-Sancha F, Nieto S, Rey Calero J. Economical saving due to prophylaxis in the prevention of surgical wound infection. Eur J Epidemiol 1996;12:455-9.
16. Akhtar S, Gondal KM, Ahmed M, Mohammad Y, Goraya AR, Karim F, Chaudhry AM. Surgical Wound Site Infection—our experience. Annals of King Edward Medical University. 2017 Oct 26;7(3).
17. leaper D .J. wound infection . In : Russell R .C., Williams N S., Bulstrode C J. editors. Bailey and love’s short practice os surgery.23^rd London: Arnold, 2000:87-98.

Dr Ananth S Mathad

General Surgeon, Davangere