scholarly journals Survey of Surgeons Regarding Prophylactic Antibiotic Use in Inguinal Hernia Repair

2018 ◽  
Vol 107 (3) ◽  
pp. 208-211 ◽  
Author(s):  
A. P. MacCormick ◽  
J. A. Akoh
Keyword(s):  
Surgical Site Infection ◽  
Perceived Risk ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Hernia Surgery ◽  
Trust Network ◽  
Surgical Trainees ◽  
Infected Mesh

Purpose: The use of prophylactic antibiotics in the mesh repair of inguinal hernias remains controversial. The aim of this study was to determine the perception of surgeons about surgical site infection and how this affects their clinical practice. Methods: A SurveyMonkey of general surgeons and senior surgical trainees was conducted via the local trust network and the questionnaire was displayed on the website of the Association of Surgeons of Great Britain and Ireland and Association of Surgeons in Training. Results: Eighty-one responses were received from surgeons who perform an average of 75 hernia repairs per year – the majority by open technique. Thirty-six (44.4%) used routine antibiotic prophylaxis, 40 (49.4%) selectively, and five (6.2%) not at all as the five surgeons who did not use antibiotics perceived their surgical site infection rate to be <1% and have never removed an infected mesh from a hernia wound. There was no clear difference between those who use prophylactic antibiotics routinely or selectively as the experience of mesh explantation is similar (56% versus 55% had 2–10 meshes removed respectively). Seventy-seven (95%) of surgeons felt a new specific set of guidelines was required. Conclusion: This study highlights the fact that in the absence of clear guidelines, most surgeons base their use of prophylactic antibiotics on their perceived risk or experience of surgical site infection. There is a strong need for a new set of guidelines to address the use of prophylactic antibiotics in groin hernia surgery.

scholarly journals Comparison of Infection Rates according to the Period of Prophylactic Antibiotic Use after Surgery in Patients with Distal Radius Fractures

2021 ◽  
Author(s):  
Joonha Lee ◽  
Yohan Lee ◽  
Yong Gil Jo ◽  
Sang Yoon Kang ◽  
Kee Jeong Bae
Keyword(s):  
Surgical Site Infection ◽  
Distal Radius ◽  
Open Reduction ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Distal Radius Fractures ◽  
Site Infection ◽  
Radius Fractures

Purpose: In general orthopedic surgery, the use of prophylactic antibiotics to prevent infection is recommended to be administered within 24 hours. However, there was no analysis on the incidence of surgical site infection according to the duration of use of prophylactic antibiotics for upper extremity fractures. This study aims to derive the appropriate prophylactic antibiotic using time by analyzing the incidence of infection according to the time of prophylactic antibiotic use in distal radius fractures.Methods: We retrospectively analyzed patients who used prophylactic antibiotics among patients who underwent open reduction and internal fixation for distal radius fractures from April 2018 to May 2021. The time of use of prophylactic antibiotics was classified into the 1-day group used, from 1 hour before surgery to 24 hours after the first administration, and the long-term group, continuously administered until discharge after surgery. Demographic characteristics, infection rate, C-reactive protein, risk factors for surgical site infection, and bone union were compared between the two groups.Results: A total of 168 patients were included in the study, 73 in the 1-day group and 95 in the long-term group. Superficial infection occurred in seven patients in the 1-day group and nine in the long-term group, and there was no statistically significant difference in the incidence rates of the two groups (p=0.980). Conclusion: The use of prophylactic antibiotics for 24 hours does not show a significant increase in the infection rate compared to the case of continuous use during open reduction and internal fixation of distal radius fractures.

scholarly journals The Use of Oral Antibiotics to Prevent Surgical Site Infection on Postoperative Modified Radical Mastectomy Patients in Dr. Soetomo General Hospital, Surabaya

2021 ◽  
Vol 56 (1) ◽  
pp. 36
Author(s):  
Norman Hadi ◽  
Hantoro Ishardyanto
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
General Hospital ◽  
Radical Mastectomy ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Oral Antibiotics ◽  
Modified Radical Mastectomy ◽  
Significant Difference

Surgical operations on modified radical mastectomy are considered clean procedures by the Centers for Disease Control and Prevention (CDC) wound classification system. Despite this, higher than expected Surgical Site Infection (SSI) rates are reported, varying from 1 % to 26 % across the literature. Some surgeons also prescribe postoperative prophylaxis for postoperative modified radical mastectomy patients to prevent infection despite its lack of proven efficacy. The aim of this study is to analyze the use of oral antibiotics to prevent Surgical Site Infection (SSI) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. This study was double-blinded randomized control trial of 60 postoperative modified radical mastectomy patients (2 groups) during the period of December 2017 to March 2018. Samples were prospectively divided into two groups (random sampling), in group A (n=30) patients received single dose prophylactic antibiotics and continued with oral antibiotics postoperative (Cefadroxil 2 x 500 mg) during 7 days and in group B (n=30) patients received single dose prophylactic antibiotics and continued without postoperative antibiotics (placebo). Both groups were evaluated clinically for surgical site infection up to 30 days. There was no statistically significant difference in both groups {p=1 (p>0.05)}. There was no incidence of surgical site infection in both groups during the 30-day follow-up period (days 3, 7, 14 and 30). There was no difference in the surgical site infection rate among those who received oral postoperative antibiotics prophylactic and without antibiotics (placebo) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. Because of the potential adverse events associated with antibiotic use, further evaluation of this practice is required.

scholarly journals Antibiotic Prophylaxis against Surgical Site Infection after Open Hernia Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-13
Author(s):  
Lolwah Al Riyees ◽  
Wedad Al Madani ◽  
Nistren Firwana ◽  
Hanan H. Balkhy ◽  
Mazen Ferwana ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hernia Repair ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Meta Analysis ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Hernia Surgery ◽  
Significant Difference

<b><i>Objective:</i></b> The role of antibiotic prophylaxis (AP) in the prevention of surgical site infection (SSI) after hernia repair is debated. We conducted this systematic review and meta-analysis to assess the evidence on the value of prophylactic antibiotics in reducing the risks of SSI after open hernia surgery. <b><i>Methods:</i></b> We ran an online and manual search to identify relevant randomized controlled trials that compared prophylactic antibiotics to nonantibiotic controls in patients undergoing open surgical hernia repair. Data on SSI risk were extracted and pooled as risk ratios (RRs) with 95% confidence intervals (95% CIs), using RevMan software. We further used the Cochrane risk of bias tool and GRADE assessment to evaluate the quality of generated evidence. <b><i>Results:</i></b> Twenty-nine studies (<i>N</i> = 8,616 patients) were included in the current analysis. Antibiotic prophylaxis reduced the risk of SSI in open hernia repair patients (RR = 0.65, 95% CI = 0.53, 0.79). Subgroup analysis showed a significant benefit for antibiotics in mesh repair patients (RR = 0.60, 95% CI = 0.48, 0.76) yet no significant difference in SSI risk after herniorrhaphy (RR = 0.86, 95% CI = 0.54, 1.36). In addition, AP was associated with a significant reduction in superficial SSI risk (RR = 0.56, 95% CI = 0.43, 0.72) but not deep SSI (RR = 0.70, 95% CI = 0.30, 1.62). Further analysis showed a significant reduction in SSI risk with amoxicillin/clavulanic acid and cefazolin but not with cefuroxime. <b><i>Conclusion:</i></b> The present meta-analysis suggests that AP is beneficial prior to open mesh hernia repair. However, the quality of evidence was low, and further well-designed trials are needed.

scholarly journals Incidence of post operative surgical site infection in thyroid surgery following single dose of prophylactic antibiotic

2020 ◽  
Vol 22 (1) ◽  
pp. 15-20
Author(s):  
Md Abul Hossan ◽  
Md Ariful Islam ◽  
Tapas Chakraborty ◽  
Firoz Ahmed Khan ◽  
Md Mozharul Islam
Keyword(s):  
Antibiotic Therapy ◽  
Surgical Site Infection ◽  
Thyroid Surgery ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Empirical Antibiotic Therapy ◽  
Site Infection ◽  
Cross Sectional

Surgical site infection after thyroid surgery is a less common incidence. Prophylactic antibiotic before surgery and empirical antibiotic therapy after surgery is a common practice in our country. But international guidelines do not suggest antibiotic in clean surgical procedure. Aim: To compare the incidence of surgical site infection after thyroid surgery with and without empirical antibiotic therapy. Method: It was a cross sectional study, done from July 2010 to December 2010 in 3 medical college hospitals in Dhaka city. Total 100 cases were included in this study, 50 cases for study in which only single prophylactic antibiotic used half an hour before operation, 50 cases for control in which 7 days antibiotic used per orally in addition to prophylaxis. Result: Among 100 cases male were 24 & female 76 (M: F= 1:3.2). Oldest patient was 56 yrs & youngest 21yrs. 47% patient operated for solitary thyroid nodule, 35% multinodular goiter & only 6% diffuse goiter. 47% patient was done hemithyroidectomy & only 7% total thyroidectomy. All the operations were completed within 2 hours where 40% within one hour. No surgical site infections were found in both study and control cases. Conclusion: There is no statistical difference between routine antibiotic use and no use of antibiotic after thyroid surgery. Bangladesh J Otorhinolaryngol; April 2016; 22(1): 15-20

scholarly journals Discordance to ASHP Therapeutic Guidelines Increases the Risk of Surgical Site Infection

2021 ◽  
Vol 14 (11) ◽  
pp. 1088
Author(s):  
Fauna Herawati ◽  
Rika Yulia ◽  
Heru Wiyono ◽  
Firdaus Kabiru Massey ◽  
Nurlina Muliani ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Surgical Procedures ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Surgical Patients ◽  
Defined Daily Dose ◽  
Site Infection ◽  
Therapeutic Guidelines ◽  
Bed Days ◽  
American Society

Clean surgery without contamination does not require prophylactic antibiotics, but there are high-risk surgical procedures that may cause infection and/or involve vital organs such as the heart, brain, and lungs, and these indeed require the use of antibiotics. This study aimed to determine the quantity of antibiotic use based on the defined daily dose (DDD) per 100 bed days and the quality of antibiotic use based on the percentage of concordance with The American Society of Health-System Pharmacists (ASHP) therapeutic guidelines (i.e., route of administration, time of administration, selection, dose, and duration). This includes the profiles of surgical site infection (SSI) in surgical patients from January through June 2019. The study subjects were 487 surgical patients from two hospitals who met the inclusion criteria. There were 322 patients out of 487 patients who had a clean surgical procedure. Ceftriaxone (J01DD04) was the most used antibiotic, with a total DDD/100 bed days value in hospitals A and B, respectively: pre-surgery: 14.71, 77.65, during surgery: 22.57, 87.31, and postsurgery: 38.34, 93.65. In addition, 35% of antibiotics were given more than 120 min before incision. The lowest concordance to ASHP therapeutic guideline in hospital A (17.6%) and B (1.9%) was antibiotic selection. Two patients experienced SSI with bacterial growths of Proteus spp., Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli. The usage of prophylactic antibiotics for surgical procedures was high and varied between hospitals. Hospital B had significantly lower concordance to antibiotic therapeutic guidelines, resulting to a higher infection rate, compared with hospital A. ASHP adherence components were then further investigated, after which antibiotic dosing interval and injection time was found to be a significant predictor for positive bacterial growth based on logit–logistic regression. Further interventions and strategies to implement antibiotic stewardship is needed to improve antibiotic prescriptions and their use.

scholarly journals Comparative study on prophylactic antibiotic versus empirical antibiotic in prevention of surgical site infection

2019 ◽  
Vol 9 (2) ◽  
pp. 9-13
Author(s):  
S Rajarajan ◽  
T.H. Sreelekshmi Devi ◽  
Neeshma Mariam Simon ◽  
K.R. Navin Shankar ◽  
V. Ganesan
Keyword(s):  
Single Dose ◽  
Comparative Study ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Prophylactic Antibiotic ◽  
Operative Therapy ◽  
Prophylactic Antibiotics ◽  
Control Group ◽  
P Value ◽  
Site Infection

The main aim of the study was to comparative study of single dose prophylactic antibiotic versus empirical postoperative antibiotics in prevention of surgical site infection. The study was a prospective observational study conducted over a period of 8months. A total of 100 number of surgery cases were selected randomly, to groups of 50 each. The study group received a single dose of antibiotic preoperatively while the control group received 3 to 5 days of empirical antibiotic therapy. Data analysis and statistical analysis was done with the help of graph pad prism trial version software. Student t test was carried out for paired analysis to find P value. There was no significant association of surgical site infection, grades of infection, and other complications. The hospital stay of patients, cost to the patients, and number of antibiotics used in patients were significantly more. The single dose prophylactic antibiotics are better than empirical post operative therapy in reducing the hospital stay and hospital cost to patients. Since the complete eradication of surgical site infection is not possible, only the reduction in infection rate can be achieved to a minimal level. Keywords: Prophylactic antibiotics, surgical site infection, surgical complications, post operative antibiotics.

scholarly journals Pattern of Perioperative Antibiotic Use in Otorhinolaryngology-Head and Neck Surgery at Third Referral Hospital In Surabaya

2020 ◽  
Vol 3 (1) ◽  
pp. 5
Author(s):  
Nabilah Puspa Utami ◽  
Dyah Fauziah ◽  
Muhtarum Yusuf
Keyword(s):  
Surgical Site Infection ◽  
Operative Procedure ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Neck Surgery ◽  
The Body ◽  
Referral Hospital ◽  
Site Infection ◽  
Cross Sectional ◽  
Perioperative Antibiotics

Introduction: Surgical site infection (SSI) often occurs in operation. SSI frequently only affects the superficial tissues, but some more serious infections can affect the deeper tissues or other parts of the body. The majority of SSIs become apparent within 30 days of an operative procedure, when a prosthetic implant is used, SSI may occur several months after the operation. To minimize surgical site infection occurrence, prophylaxis antibiotic is often used. The aim of the study is to evaluate the use of perioperative antibiotics for otorhinolaryngology surgery in third referral hospital in Surabaya.Methods: This study was a retrospective cross-sectional method through the medical record of patients cases from December 2017 to January 2018. All data about sex, age, diagnosis, wound classification, surgical intervention including ICD 9 CM codes, and antibiotics regiments are presented descriptively.Results: Of total 68 patients, 42 (61.8%) were male and 46 (61.8%) were aged 18-65 years old. The most common type of operation was clean surgery 52 (76.5%). The most common prophylactic antibiotic was cefazoline 25 (96.6%). Conclusion: Most of the performed surgery was clean surgery. The use of perioperative antibiotics in most performed operations was in accordance with existing literature. The most widely used prophylactic and therapeutic antibiotic was cefazoline and ceftriaxone, respectively. Further research about risk factor of SSI, the use of prophylaxis antibiotic, and bacterial profile with more samples is needed for more accurate results.

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