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A Randomized Controlled Study of Single-Dose Antibiotic Prophylaxis for Clean Surgeries

Yalagachin, Gurushantappa Halappa MS, DNB, FIAMS, FIAGES; Raman, Prashant MBBS, MS; Huchchannavar, Suresh MS, FGIS, FLAP, FIAGES

Infectious Diseases in Clinical Practice: January 2018 - Volume 26 - Issue 1 - p 39–44
doi: 10.1097/IPC.0000000000000552
Original Articles
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Objectives The aims of this study were to establish the use of single-dose prophylactic intravenous antibiotics in the prevention of postoperative wound infection following clean surgeries in a government setup in India and to assess the efficacy of single-dose prophylactic ceftriaxone in preventing surgical site infection following clean surgeries by a prospective randomized trial.

Methods A prospective study was done on patients in the Department of General Surgery in Karnataka Institute of Medical Sciences, Hubli, Karnataka, India, from January 2011 to December 2014. A total of 822 patients were divided into 2 groups. The first group (A), consisting of 406 patients, received a single-dose antibiotic prophylaxis, and the second group (B), consisting of 416 patients, received 3 days or more of postoperative doses of antibiotic therapy. Only clean procedures are included, and results were compared.

Results In the first group (A), the rate of infection was 4 of 406. In the second group (B), the rate of infection was 6 of 416. Overall wound infection rate was 0.95%; wound infection rate after administration of single-dose preoperative antibiotic was 0.96%, and in the routine postoperative group, it was 0.94% (P = 0.9).

Conclusions This study concludes that single-dose preoperative antibiotic alone is as effective as the use of empiric antibiotics given for 3 days or more in clean surgeries. It will facilitate in decreasing superinfections among and resistance to bacterial strains, health care costs, and morbidity secondary to antibiotic administration (eg, drug toxicity, antibiotic-related diarrhea) in a developing country such as India.

Use of single-dose antibiotics in elective clean surgeries is as effective as using 3 to 7 days of antibiotics routinely to prevent surgical site infection. This will reduce total expenses incurred by the patient and the institute, and in turn save national medicare expenses.

From the Department of General Surgery, Karnataka Institute of Medical Sciences, Hubballi, India.

Correspondence to: Gurushantappa Halappa Yalagachin, MS, DNB, FIAMS, FIAGES, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India. E-mail: d.yalagachin@yahoo.com.

The authors have no funding or conflicts of interest to disclose.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.