scholarly journals Comparison of single dose versus multiple doses of antibiotic prophylaxis for prevention of surgical site infection

2021 ◽  
Vol 9 (1) ◽  
pp. 129
Author(s):  
Swapan Das ◽  
Rajib Kundu ◽  
Bani Prasad Chattopadhyay
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Multiple Dose ◽  
Cost Effective ◽  
Site Infection ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Clean Contaminated

Background: Surgical site infection is a common problem following general surgical procedures. Despite major improvement in antibiotics, improved antiseptic measures SSI continues to present a big challenge. In this study we will compare single dose versus multiple dose antibiotic prophylaxis for prevention of SSI in clean and clean contaminated surgical wound.Methods: This is an institution based prospective, comparative study, with total 60 patients as study population. Clinical finding, wound swab culture and routine haematological reports were taken as study variables. Patients receiving single dose antibiotic and multiple dose antibiotic were included in ‘Group A’ and ‘Group B’ respectively. The surgical sites were examined from post-operative days 3 to 8 for signs of infection.Results: In This study, 46.7% patients were female, and 53.3% patients were male. In Group-A, patients having post operative fever, tachycardia and leucocytosis were 16.7%, 13.3% and 20.0% respectively. 6.7% patients had purulent and 10.0% patients had seropurulent discharge from wound. In Group-B, patients having post operative fever, tachycardia, and leucocytosis were 13.3%, 16.7% and 13.3% respectively. 6.7% patients had purulent and seropurulent discharge from wound. There is no statistically significant difference between two groups regarding post operative fever, tachycardia, leucocytosis and wound discharge.Conclusions: There is no significant difference between single dose and multiple dose antibiotic prophylaxis to prevent SSI in patients for elective clean and clean contaminated surgery however single dose is more cost effective.

scholarly journals Prophylactic use of antibiotics as per SIGN 104 guidelines versus routine antibiotic prophylaxis for prevention of surgical site infection in clean and clean contaminated ENT surgical procedures: a comparative study

2019 ◽  
Vol 6 (1) ◽  
pp. 106
Author(s):  
M. Bharath ◽  
J. R. Galagali ◽  
Awadhesh Kumar Mishra ◽  
Ajay Mallick ◽  
E. Nikhilesh
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Antibiotic Use ◽  
Site Infection ◽  
Significant Difference ◽  
Group A ◽  
Prophylactic Use ◽  
Group B ◽  
Clean Contaminated

<p class="abstract"><strong>Background:</strong> Many clinicians continue to use antibiotic prophylaxis routinely in all surgical procedures, ignoring the guidelines issued by policy makers. In this prospective study we compared the rate of surgical site infection (SSI) in patients who received prophylactic antibiotics as a routine; with the rate of SSI in patients getting antibiotics strictly as per SIGN 104 Guidelines, for clean and clean contaminated procedures.</p><p class="abstract"><strong>Methods:</strong> The study population comprised 235 patients. Group A consisted of 119 patients having 77 (65%) males and 42 (35%) females while Group B had 116 patients - 71 (61%) males and 45 (39%) females. Group A received routine antibiotic prophylaxis in all cases, while Group B received antibiotic prophylaxis as per SIGN 104 guidelines only. Both the groups were followed up for one month post-operatively for SSI and complications.</p><p class="abstract"><strong>Results:</strong> SSI occurred in 2 patients (1.68%) in Group A and in 3 (2.59%) patients in Group B. There was no significant difference in the rate of SSI between the two groups (p=0.68). Procedure wise maximum SSI occurred in tympanoplasty and laryngectomy. Due to infection one case of tympanoplasty had graft failure and one case of laryngectomy had delayed wound healing. No major complications related to infection or antibiotic use occurred in either group.</p><p class="abstract"><strong>Conclusions:</strong> Selective use of antibiotic prophylaxis as per SIGN 104 Guidelines does not lead to increase in SSI in clean and clean contaminated ENT procedures.</p>

scholarly journals Comparative study of single dose preoperative antibiotic versus five days antibiotic course in preventing surgical site infection for pediatric inguinal herniotomy

2021 ◽  
Vol 7 (3) ◽  
pp. 134-139
Author(s):  
Pinaki Ranjan Debnath ◽  
Arnab Kumar Saha ◽  
Rashmi D ◽  
Vasu Gautam ◽  
Chetna Khanna ◽  
...  
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Wound Care ◽  
Oral Antibiotic ◽  
Site Infection ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Inguinal Herniotomy

To compare single dose preoperative antibiotic versus five days antibiotic course in preventing surgical site infection for the pediatric inguinal herniotomy.The present study was conducted on 100 patients of elective inguinal herniotomy from January 2019 to April 2020 and compared on the basis of single dose preoperative antibiotic versus five days antibiotic course. All the patients were evaluated on the 3rd, 7th and 28th post-operative period and instructions were given to the guardians about wound care and to attend for early follow up if any signs & symptoms of wound infection appear.50% of the patients were treated with prophylactic single dose antibiotic, i.e. inj. Ceftriaxone (30 mg/kg/dose) at the time of induction only and rest 50% were treated with inj. Ceftriaxone(30mg/kg/dose) at the time of induction as well as postoperatively at night followed by four days of oral antibiotic with Syr/Tablet. Cephalexin (25mg/kg/day) three times daily for another 4 days.Surgical Site Infection (SSI) in Group-B (4.0%) was higher than that of Group-A (2.0%) on day 3 but it was not significant (p=0.40). There was no significant difference in health status of the patients of the two groups when compared on post-operative day 7 and day 28 (p=0.99, p=0.99 respectively).Implementation of single dose antibiotic prophylaxis regimes tailored to the prevalent organisms in the institution can result in enormous savings, as the study shows significant reduction in hospital stay with no significant increase in incidence of SSI.

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

2015 ◽  
Vol 1 (2) ◽  
pp. 8-10
Author(s):  
Kamal Koirala ◽  
Rupesh Mukhia ◽  
Suman Sharma ◽  
Sujan Manandhar ◽  
Niroj Banepali ◽  
...  
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Diabetic Patients ◽  
Outpatient Basis ◽  
Site Infection ◽  
Significant Difference ◽  
Group 2 ◽  
Clean Contaminated ◽  
Group 1

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.

scholarly journals Intra-incisional versus intravenous route of antibiotic administration in preventing surgical site infections: a randomized controlled trial

2018 ◽  
Vol 5 (4) ◽  
pp. 1438
Author(s):  
Aditya N. Patil ◽  
Veerendra M. Uppin
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Intravenous Route ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Open Appendicectomy ◽  
Group A ◽  
Group B

Background: Surgical site infection (SSI) is one of the most common postoperative complications following abdominal surgeries. Whilst the use of prophylactic antibiotics has been shown to reduce postoperative wound infection, controversy still remains as to the optimum route of administration and the duration of treatment. This study aims to compare the efficacy of a preoperative single dose of a cephalosporin antibiotic (cefotaxime) administered intraincisionally versus that administered intravenously, in preventing postoperative surgical site infections following appendicectomy.Methods: Sixty consecutive cases diagnosed as uncomplicated appendicitis who consented for open appendicectomy at a tertiary care institute were included in the study. Cases were randomized to 2 comparable groups of 30 patients each. Preoperatively, patients in Group A received a single dose of Inj. Cefotaxime 1g intraincisionally while those in Group B received the same intravenously. Incision sites were examined every alternative day starting on postoperative day 3 until removal of sutures. Signs of surgical site infection, if any, were recorded and outcomes were statistically tested for significance.Results: One patient in Group A (3.3%) and 4 patients in Group B (13.3%) showed signs of postoperative surgical site infection (p >0.05) during the follow up period which prolonged their hospital stay.Conclusions: This study showed that a single dose preoperative intraincisional administration of cefotaxime was as effective as intravenous administration for prevention of postoperative surgical site infection after open appendicectomy. Although the difference was not statistically significant, there was a reduced incidence of SSI in individuals who received intraincisional antibiotic. These results are encouraging for a way forward in reducing unnecessary burdening of systemic antibiotics in patients undergoing abdominal surgeries. 

scholarly journals Single vs Multiple Antibiotic Drug Regimen in Preventing Infectious Morbidity in Caesarean Section: A Randomised Clinical Trial

2021 ◽  
Author(s):  
Subhashchandra R Mudanur ◽  
Shreedevi S Kori ◽  
Aruna Biradar ◽  
Rajasri G Yaliwal ◽  
Dayanand S Biradar ◽  
...  
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Multiple Dose ◽  
Caesarean Delivery ◽  
Surgical Site Infections ◽  
Cost Effective ◽  
P Value ◽  
Infectious Morbidity ◽  
Group A ◽  
Group B

Introduction: Surgical site infections are a serious cause of maternal morbidity and mortality. Various preventive measures are being used to reduce the incidence of surgical site infections. One of them is the use of prophylactic antibiotics. In this study, authors have evaluated three antibiotic regimen with respect to preventing infectious morbidity in caesarean section. Aim: To study the efficacy and cost-effectiveness of a single dose (ceftriaxone) versus multiple doses of antibiotic therapy (ceftriaxone and ornidazole) administered preoperatively in women undergoing caesarean delivery. Materials and Methods: A prospective interventional study was conducted on 300 pregnant women undergoing emergency or elective caesarean delivery. Study was conducted at BLDE (DU) Shri BM Patil Medical College and Research Centre, Vijayapur, Karnataka, India. Patients were randomly assigned to three groups by block random sampling with 100 women in each group. Group A received Inj. ceftriaxone 1 gm single dose 60 minutes prior to commencement of surgery. Group B received Inj. ceftriaxone 1 gm along with Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and Group C received Inj. ceftriaxone 1 gm and Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and a repeat dose 12th hourly for 24 hours followed by Tab. cefixime 200 mg and Tab. ornidazole 500 mg twice daily for four days postoperatively. The effectiveness of therapy was measured in terms of adverse effects of antibiotics such as nausea and vomiting and postoperative complications like pyrexia, foul smelling lochia, surgical site infections, uterine tenderness, peritonitis and endometritis. Results: There was no statistical difference in outcome measures in side-effects of antibiotics (p-value=0.13), fever (p-value=0.68), lochia discharge (p-value=0.88), wound infection (p-value=0.39) and peritonitis (p-value=0.30) among the three groups. The single dose medication in group A had a cost of Rs.60 INR (0.82 cents USD), which was significantly less compared to the multiple dose regimens in group B that cost Rs.203 INR ($2.76 USD). The mean hospital stay in non infectious and infectious patients were 5 and 10 days in present study (p<0.0001). Conclusion: Caesarean delivery poses 5-20 times greater risk of postoperative infection when compared to vaginal birth. There has been a shifting trend of increasing caesarean deliveries and postoperative infections can contribute to overwhelming health and economic burden. Present study shows outcome measures which were statistically insignificant among the three study groups with different prophylactic regimen for caesarean delivery, so it’s safe to state that both single dose and multiple dose regimen provided equal protective coverage in reducing maternal infectious morbidity. Also, single dose regimen proved to be cost-effective. So, to conclude single dose prophylactic antibiotic given preoperatively in caesarean section is both cost-effective and as is efficient.

scholarly journals Comparative study of single dose preoperative antibiotics versus both preoperative and postoperative antibiotics in laparoscopic appendicectomy for nonperforated appendicitis

2017 ◽  
Vol 4 (9) ◽  
pp. 3092
Author(s):  
Himabindu Bangaru ◽  
Varun V. Gaiki ◽  
M. V. Ranga Reddy
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Prophylactic Antibiotics ◽  
Postoperative Hospital Stay ◽  
Laparoscopic Appendicectomy ◽  
Site Infection ◽  
Significant Difference ◽  
Group A ◽  
Preoperative Antibiotics

Background: Antibiotics are being administered both preoperatively and postoperatively even in uncomplicated nonperforated appendicitis. Studies regarding role of postoperative antibiotics in laparoscopic appendicectomy for nonperforated appendicitis are sparse. The aim of the study is therefore to study the efficacy of single dose preoperative antibiotics versus both preoperative and postoperative antibiotics in reducing surgical site infection in laparoscopic appendicectomy for uncomplicated nonperforated acute appendicitis.Methods: This is a prospective study done in general surgery department at Malla Reddy institute of medical sciences from September to April 2016.162 patients with nonperforated appendicitis were randomly allocated into two groups. 80 patients in Group A were given single dose of preoperative prophylactic antibiotics. No further antibiotics were given. 82 patients in Group B were given both preoperative and postoperative antibiotics. Postoperative surgical site infection and duration of postoperative hospital stay were compared between both groups. Statistical analysis was done using ANOVA, Fisher’s Exact test and Chi-square test wherever necessary.Results: There was no significant difference in the rate of surgical site infection in both groups. The mean duration of postoperative hospital stay was shorter in preoperative antibiotics only group (Group A). Age and gender had no significant association with surgical site infection. There was no deep incisional or organ space infection in this study.Conclusions: Single dose prophylactic antibiotics would be sufficient in cases of laparoscopic appendicectomy for simple uncomplicated nonperforated acute appendicitis. Postoperative antibiotic administration would not be necessary in these cases.

A Comparative Study of Single Dose and Multiple Dose Antibiotic Prophylaxis In Caesarean Section

2021 ◽  
Vol 8 (3) ◽  
pp. 89-93
Author(s):  
Dr. Poorvi Agarwal ◽  
Dr. Harshal Nimbannavar ◽  
Dr. Prajakta Khose ◽  
Dr. Supraja Subramanian ◽  
Dr. Himadri Bal
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Antibiotic Prophylaxis ◽  
Multiple Dose ◽  
Prophylactic Antibiotic ◽  
Dose Schedule ◽  
Antibiotic Use ◽  
Skin Incision ◽  
Significant Difference ◽  
Group B

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.

scholarly journals Pharmacokinetics Interaction between Imatinib and Genistein in Rats

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Zhe Wang ◽  
Li Wang ◽  
Meng-ming Xia ◽  
Wei Sun ◽  
Cheng-ke Huang ◽  
...  
Keyword(s):  
Single Dose ◽  
Multiple Dose ◽  
Pharmacokinetic Parameters ◽  
Control Group ◽  
Sprague Dawley ◽  
Sprague Dawley Rats ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group Control Group

The objective of this work was to investigate the effect of orally administered genistein on the pharmacokinetics of imatinib and N-desmethyl imatinib in rats. Twenty-five healthy male SD (Sprague-Dawley) rats were randomly divided into five groups: A group (control group), B group (multiple dose of 100 mg/kg genistein for consecutive 15 days), C group (multiple dose of 50 mg/kg genistein for consecutive 15 days), D group (a single dose of 100 mg/kg genistein), and E group (a single dose of 50 mg/kg genistein). A single dose of imatinib is administered orally 30 min after administration of genistein (100 mg/kg or 50 mg/kg). The pharmacokinetic parameters of imatinib and N-desmethyl imatinib were calculated by DAS 3.0 software. The multiple dose of 100 mg/kg or 50 mg/kg genistein significantly (P<0.05) decreased theAUC0-tandCmaxof imatinib.AUC0-tand theCmaxof N-desmethyl imatinib were also increased, but without any significant difference. However, the single dose of 100 mg/kg or 50 mg/kg genistein has no effect on the pharmacokinetics of imatinib and N-desmethyl imatinib. Those results indicated that multiple dose of genistein (100 mg/kg or 50 mg/kg) induces the metabolism of imatinib, while single dose of genistein has no effect.

scholarly journals Role of Single Dose Preoperative Ceftriaxone in the Control of Surgical Site Infection in a Tertiary Level Hospital

2016 ◽  
Vol 11 (1) ◽  
pp. 6-10
Author(s):  
Mohammad Mushfiqur Rahman ◽  
Md Mazedur Rahman ◽  
Mamun Ibn Munim ◽  
Md Shariful Haque
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Financial Burden ◽  
Cross Sectional Study ◽  
Site Infection ◽  
College Hospital ◽  
Cross Sectional ◽  
Group I ◽  
Significant Difference ◽  
Clean Contaminated

Post-surgical wou  infection is a crucial factor in surgical practice. Prolong use of postoperative antibiotic is common practice in our surgical world. This causes financial burden to our patients a antibiotic resistance. But international journals a  literatures suggest using antibiotics as prophylaxis only at the time of operation a  no further postoperative antibiotic is needed in clean contaminated surgery. This comparative cross-sectional study was done at the department of surgery, Sylhet MAG Osmani Medical College Hospital from 1st July 2007 to 30th June 2008. A total number of 100 patients of clean-contaminated elective laparotomy were selected. Patients were ra omly divided into two groups, in Group-I (got single dose preoperative Inj. Ceftriaxone) a  in group-II (got single dose preoperative Inj. Ceftriaxone followed by Inj. Ceftriaxone for 2 days a  then Cap. Cefxime for next 5 days). There is no statistically significant difference in outcome between two groups. So, single dose preoperative Inj. Ceftriaxone (1gm) is sufficient as a prophylaxis of surgical site infection in clean-contaminated elective surgery.Faridpur Med. Coll. J. Jan 2016;11(1): 6-10

scholarly journals Prophylactic Antibiotics in Elective Laparoscopic Cholecystectomy is it Necessary?

2018 ◽  
Vol 16 (2) ◽  
pp. 16-18
Author(s):  
Anup Sharma ◽  
Arun Shah
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Dose ◽  
Surgical Site Infection ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Medical College ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B

Background: Elective laparoscopic cholecystectomy (LC) has a low risk for Surgical Site Infection (SSI). In spite many surgeons still use prophylactic antibiotics. The aim of this study was to find out the need of prophylactic antibiotics in elective LC. Method: This study was carried out from 2017 June to 2018 August in the Department of Surgery Nepalgunj Medical College and Teaching Hospital Kohalpur (NGMC). Patients were placed into two groups. Group A received a single dose of prophylactic antibiotic and group B patients did not receive any prophylactic antibiotic. In both groups the SSI were recorded and compared. Results: Overall SSI was 5(3.33%) among 150. In group A 2 (2.66%) patients had SSI and in group B 3 (4%) had SSI. Using or not using prophylactic antibiotics did not correlate with SSI (p= .154). Conclusions: Prophylactic antibiotic is not recommended in elective LC. Prophylactic antibiotic does not reduce the rate of SSI.

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