A single-dose antibiotic prophylaxis to prevent surgical site infection in clean-contaminated surgery among diabetic patients

Kamal Koirala, Rupesh Mukhia, Suman Sharma, Sujan Manandhar, Niroj Banepali, Rishikesh Narayan Shrestha, Mahesh Khakurel, Bijendra Raj Raghubanshi, Balman Singh Karki

Abstract


Introductions: Guidelines on antibiotics use in surgical patients recommends a
single dose prophylaxis for clean-contaminated cases and therapeutic course
for contaminated and dirty cases. Compliance to this guideline is poor among
diabetic patients. The aim of this study was to test the efficacy of single dose
antibiotic prophylaxis on the occurrence of postoperative surgical site infection
(SSI) in clean-contaminated surgery in diabetic patients.

Methods: Retrospective cross-sectional study was carried out at KIST Medical
College and Teaching Hospital from September 2008 to August 2012 involving
144 diabetic patients who underwent major clean-contaminated surgery. Forty
eight patients received one gram of ceftriaxone intravenously as prophylactic
antibiotic within 30 minutes prior to incision (group 1) and 96 patients received
three doses of ceftriaxone (group 2). One dose was given within 30 minutes
prior to incision and other two doses were given postoperatively. All patients
were followed up for 30 postoperative days on outpatient basis. The SSI rates
were compared in two groups. Pus from the infected wound was tested for
culture and sensitivity.

Results: The SSI rates in group 1 and group 2 were of 5/48 (10.42%) and of 9/96 (9.37%) respectively. There was no significant difference in SSI rates between group 1 and group 2 (p=0.322).

Conclusions: Single dose of Ceftriaxone shows the similar effect as three doses
in clean-contaminated surgery in diabetic patients.

Keywords: antibiotic prophylaxis, diabetic patients, surgical site infection


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