Antibiotic prophylaxis in elective gastro-intestinal tract surgery: a comparison of single-dose pre-operative cefotaxime and multiple-dose cefoxitin

Background: Rampant antibiotic use brought about its own set of problems like the rise in incidence of antibiotic resistant strains, allergies and other complications of antibiotic use. Unfortunately in many of our set ups we are still stuck in prolonged post-operative antibiotic regimes. This study aims to fill that lacunae and thereby aid our gradual shift away from over reliance on prolonged antibiotic usage in prevention of SSI. Hence we decided to investigate the efficacy of the use of a single prophylactic intravenous dose of antibiotic vis a vis multiple doses in reducing post-operative infective morbidity in caesarean sections. Methods: The study included 200 patients at term, satisfying the inclusion and exclusion criteria, reporting to the labour room and undergoing caesarean section. The patients were then divided into two groups of 100 each by simple randomization. Patients in Group A were given a single dose of Inj. Cefotaxime 1gm IV + Inj. Metronidazole 500 mg IV infusion 30 minutes before the skin incision. Group B cases were given the first dose of Inj. cefotaxime 1g IV + Inj. metronidazole 500 mg IV 30 minutes before the skin incision followed by injectables for 2 days: Inj. cefotaxime 1g IV BD and Inj. metronidazole 500mg IV TDS. Subsequently for the next 3 days Tablet Cefixime 200mg BD and Tablet Metronidazole 400mg TDS were administered orally. Results: The present study did not show any significant difference in the post operative infection incidence between the single dose and multiple dose schedule. Conclusion: our study makes an important observation regarding use of antibiotic prophylaxis and its duration for prevention of post operative infections in mothers without compromising any safety aspects of either the mother or the child. As noted in our study, there was no difference in the outcome as regards post operative infectious morbidity in patients of both the groups. Hence, based on the findings of our study we conclude that single dose prophylactic antibiotic should be the norm for caesarean sections.

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Antibiotic Prophylaxis In Prostate Biopsy: A Comparative Study Between Single Dose & Multiple Doses Of Ciprofloxacin

Bangladesh Journal of Urology ◽

10.3329/bju.v16i1.45928 ◽

2020 ◽

Vol 16 (1) ◽

pp. 5-10 ◽

Cited By ~ 1

Author(s):

Md Sirajul Islam ◽

Ma Awal ◽

Sm Mahbub Alam

Keyword(s):

Single Dose ◽

Antibiotic Prophylaxis ◽

Prostate Biopsy ◽

Multiple Dose ◽

Dose Group ◽

Statistical Significance ◽

College Hospital ◽

Medical College ◽

Multiple Doses ◽

Quasi Experimental

Objective: To compare the effect of single dose and multiple doses of ciprofloxacin as prophylaxis for prostate biopsy. Method and material: This was a prospective quasi-experimental study carried in the department of Urology, Dhaka Medical College Hospital over seventy patients undergoing prostate biopsy. Half of the patients received single dose of ciprofloxacin and the rest half received three doses of the same drug as antibiotic prophylaxis. Result: Two patients from single dose group and one patient from multiple dose group developed urinary tract infection without any statistical significance Conclusion: Single dose of ciprofloxacin has equal clinical and bacteriological efficacy as that of multiple doses of the same drug for prophylaxis in prostate biopsy. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2013 p.5-10

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Similar risk of complete revision for infection with single-dose versus multiple-dose antibiotic prophylaxis in primary arthroplasty of the hip and knee: results of an observational cohort study in the Dutch Arthroplasty Register in 242,179 patients

Acta Orthopaedica ◽

10.1080/17453674.2020.1794096 ◽

2020 ◽

pp. 1-7

Author(s):

Ewout S Veltman ◽

Erik Lenguerrand ◽

Dirk Jan F Moojen ◽

Michael R Whitehouse ◽

Rob G H H Nelissen ◽

...

Keyword(s):

Cohort Study ◽

Single Dose ◽

Antibiotic Prophylaxis ◽

Multiple Dose ◽

Observational Cohort Study ◽

Arthroplasty Register ◽

Primary Arthroplasty ◽

Observational Cohort ◽

Similar Risk

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Comparison of single versus multiple doses of antibiotic prophylaxis in reducing post-elective Caesarean section infectious morbidity

Kathmandu University Medical Journal ◽

10.3126/kumj.v8i2.3554 ◽

1970 ◽

Vol 8 (2) ◽

pp. 179-184 ◽

Cited By ~ 8

Author(s):

A Shakya ◽

J Sharma

Keyword(s):

Urinary Tract Infection ◽

Single Dose ◽

Caesarean Section ◽

Antibiotic Prophylaxis ◽

Multiple Dose ◽

Elective Caesarean Section ◽

Infectious Morbidity ◽

Prophylactic Dose ◽

Cord Clamping ◽

Febrile Morbidity

Background: Puerperal sepsis is frequently in Caesarean section. Antibiotic prophylaxis may have significant impact in reduction of infections and thus the need to study its role in sepsis prevention systematically. Objective: The aim of this study is to compare the efficacy of single dose versus multiple doses of a first generation cephalosporin (with Metronidazole), to reduce postoperative infectious morbidity in elective caesarean section. Materials and methods: It was prospective clinical trial of hundred women undergoing elective caesarean section who received either a single prophylactic dose of Cefazolin with Metronidazole post-cord clamping, or multiple postoperative doses of antibiotics based on the standard protocol of the hospital. Duration of the study was seven months and twentytwo days (11th November 2004 to 30th June 2005).Women were compared on the basis of development of postoperative febrile morbidity, endometritis, urinary tract infection, wound infection and other infections. Results: There were no significant differences among the patients in single and multiple dose groups in terms of their age distribution, gravida, period of gestation, smoking status, body mass index, indications for elective caesarean section or operation characteristics. There were 4% and 6% febrile morbidity, 2 (4%) and 0 (0%) urinary tract infection, in the single dose and multiple dose groups respectively. But none of the differences were statistically significant. Conclusion: A single prophylactic dose of Cefazolin plus Metronidazole given post-umbilical cord clamping gives as much protection as multiple postoperative doses of Cefazolin/Cefalexin plus Metronidazole in preventing postoperative infectious morbidity in elective caesarean section. Key words: Antibiotic prophylaxis; Caesarean section DOI: 10.3126/kumj.v8i2.3554 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 179-184

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