Single dose Intraoperative Antibiotics versus  Postoperative Antibiotics for Patient Undergoing Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis

Introduction: Surgical site infection is a common complication shown in literature following cholecystectomies. Smaller incision and use of trocars in laparoscopic cholecystectomy lessen the contamination resulting in less chances of surgical site infection. However, in fear of postoperative infection, many opt for the prolonged postoperative use of antibiotic and there is growing consensus against it. Antibiotics not only increases the cost and hospital stay duration but it aids in emergence of multidrug resistance. Because of the controversies, we conducted this clinical trial to see whether a single prophylactic dose of antibiotic at the time of induction of anesthesia for laparoscopic cholecystectomy was equally effective in controlling post-operative infection as multi-dose antibiotics during and post-operative period. Methods: The study was conducted at the department of general surgery, Lumbini Medical College Teaching Hospital, from November 2015 to October 2016. All cases with symptomatic cholelithiasis subjected for laparoscopic cholecystectomy were enrolled. Patients were randomized into two groups; Group SD received single dose of an intravenous dose of amikacin 500 mg, at induction of anesthesia and Group MD received multiple intravenous dose of amikacin, during and postoperatively for two days. Complications, hospital stay, and treatment cost in two groups were compared and analyzed. Results: There were a total of 240 patients in the study, 118 in Group SD and 122 in Group MD. Post-operative infection rate was 4.2% (n= 5, N=118) in Group SD and 3.3% (n=4, N=122) in Group MD; the difference was not significant (p=0.75). Hospital stay was prolonged and cost was higher significantly in Group MD. Conclusion: Single dose of prophylactic antibiotic, administered at induction of anesthesia, is equally effective as multiple doses of post surgical antibiotics to prevent post-operative infection in patients undergoing elective laparoscopic cholecystectomy for uncomplicated cholelithiasis.

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Single dose Intraoperative Antibiotics versus Postoperative Antibiotics for Patient Undergoing Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis

Journal of Lumbini Medical College ◽

10.22502/jlmc.v0i0.112 ◽

2017 ◽

pp. 5

Author(s):

Sagun Bahadur Thapa ◽

Yashwant Ramakrishan Kher ◽

Yashwant Gajanan Tambay

Keyword(s):

Laparoscopic Cholecystectomy ◽

Single Dose ◽

Surgical Site Infection ◽

Hospital Stay ◽

Prophylactic Antibiotic ◽

College Teaching ◽

Intravenous Dose ◽

Site Infection ◽

Symptomatic Cholelithiasis ◽

The Difference

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

Journal of Drug Delivery and Therapeutics ◽

10.22270/jddt.v9i2.2344 ◽

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.

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Eﬃcacy of Single Dose versus Multiple Dose of Pre-Operative Antibiotic: Teaching Hospital Based Study

Academia Journal of Surgery ◽

10.47008/ajs/2020.3.2.7 ◽

2020 ◽

Vol 3 (2) ◽

pp. 25-29

Author(s):

Kamta Prasad Gupta ◽

Dinesh Pratap Singh

Keyword(s):

Laparoscopic Cholecystectomy ◽

Single Dose ◽

Surgical Site Infection ◽

Prophylactic Antibiotic ◽

Invasive Procedure ◽

Anesthesia Induction ◽

Site Infection ◽

Time Period ◽

Study Results ◽

Elective Laparoscopic Cholecystectomy

Background: The major crisis in any type of surgery is understood to be Surgical Site Infection (SSI). Although laparoscopic cholecystectomy is a nominally invasive procedure, there is a dominant prevalence of SSI in patients. It is also believed that prophylactic antibiotic has major impact in reducing SSI. Subjects & Methods: Seventy cases were enrolled in this study with knowledgeable consent. The study was carried out over a time period of ten months. The subjects acknowledge for elective laparoscopic cholecystectomy were incorporated in our study. Results: Out of the 70 randomized patients, 35 were allotted in single dose (SD group) while 35 patients were allotted in multiple doses (MD group), who got planned treatments and were then investigated. Of the 70 patients, female patients were 58(82.9%) and males were 12(17.1%). Total 43.62 12.18 years was the mean age of patients having symptomatic cholelithiasis, with 18 years as minimum and 77 years as maximum age. The peak of disease was documented in the age group of 30 to 39 years (28.6%). Conclusion: Utility of single antibiotic dose before anesthesia induction in laparoscopic cholecystectomy was likewise efficient as the use of multiple antibiotics doses in surgical site infection of postoperative periods.

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Prophylactic Antibiotics in Elective Laparoscopic Cholecystectomy is it Necessary?

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v16i2.24866 ◽

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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Single dose versus multiple dose antibiotics in laparoscopic cholecystectomy: A prospective comparative single blind study

Journal of Society of Anesthesiologists of Nepal ◽

10.3126/jsan.v5i1.23212 ◽

2019 ◽

Vol 5 (1) ◽

pp. 11-15

Author(s):

Ashok Koirala ◽

Dipendra Thakur ◽

Sunit Agrawal ◽

Bhuwan Lal Chaudhary

Keyword(s):

Laparoscopic Cholecystectomy ◽

Single Dose ◽

Surgical Site Infection ◽

Multiple Dose ◽

Randomized Study ◽

Prophylactic Antibiotics ◽

Site Infection ◽

Medical College ◽

Symptomatic Cholelithiasis ◽

Multiple Doses

Introduction: There is a controversy on single dose or multiple doses of prophylactic antibiotics for prevention of surgical site infection during laparoscopic cholecystectomy in a developing country setting. The objective of this study was to compare single versus multiple doses of prophylactic antibiotics in terms of surgical site infection in laparoscopic cholecystectomy patients. Methods: This was a prospective, comparative, randomized study was conducted in a medical college hospital. Two hundred consecutive patients with symptomatic cholelithiasis planned for routine laparoscopic cholecystectomy were enrolled in the study. Patients were randomly divided in a Single dose (SD) group and multiple dose (MD) group. SD group were given injection ceftriaxone (1gm) before induction of anesthesia and MD group received ceftriaxone (1gm) before induction of anesthesia and continued a total of 3 doses postoperatively for next 24 hours. Results: A total of 200 patients were studied, of which 100 were in single dose (SD group) and another 100 in multiple dose (MD group). The mean age of patients with symptomatic cholelithiasis was 41.76 ± 13.38 years with minimum of 16 years and maximum of 73 years. Of the total patients, 4 patients in single dose (SD) group and 3 patients in multiple dose (MD) group developed surgical site infection of various severity which was not statistically significant. (p=0.500). Conclusion: There is no difference in terms of surgical site infection in patients taking either single or multiple doses of antibiotics in laparoscopic cholecystectomy in a medical college setting in Nepal.

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The Incidence of Surgical Site Infection in Acute Non Perforated Appendicitis

Journal of Chitwan Medical College ◽

10.3126/jcmc.v9i2.24525 ◽

2019 ◽

Vol 9 (2) ◽

pp. 11-14

Author(s):

Suraj Raj Bhattarai ◽

Kishor Kumar Tamrakar

Keyword(s):

Single Dose ◽

Surgical Site Infection ◽

Perforated Appendicitis ◽

College Teaching ◽

Cross Sectional Study ◽

Age Group ◽

Site Infection ◽

Cross Sectional ◽

Significant Difference ◽

Group Sex

Background: Appendectomy is the most commonly performed emergency surgical procedure and has significant morbidity of surgical site infection (SSIs). Regarding this, there are conflicting reports and dilemma on use of optimal duration of antibiotics. The aim of this study was to evaluate the incidence of SSIs after three doses of perioperative prophylactic antibiotics (single dose before surgery and two doses postoperatively) after appendectomy in acute non- perforated appendicitis (NPA). Methods: This cross sectional study was conducted in the department of General surgery, Chitwan Medical College Teaching Hospital, from May 2018 to April 2019. All the cases received single dose of antibiotics (ceftriaxone and metronidazole) during the induction of anesthesia and two doses of the same antibiotics postoperatively within 24 hours. SSIs was assessed on 2nd and followed up till 7th postoperative day. The data collected was analyzed using SPSS version 16. Results: In the study of 100 patients, who received perioperative three doses of antibiotics, the overall frequency of SSIs on 2nd and 3rd post-operative day were 2% (p=.840) and 6% (p=.539) respectively, which was statistically not significant. In follow up after 3rd postoperative day, there was no evidence of SSIs. Statistically there was no significant difference in the incidence and grade of SSIs between age group, sex and duration of operation. Conclusions: A combined three doses of perioperative antibiotics was adequate for SSIs prevention in patients of any age group and sex with acute NPA after appendectomy in usual operative time.

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Abstract P1-20-09: Does a single-dose of pre-operative prophylactic antibiotic reduce surgical site infection following wire-localized lumpectomy?

10.1158/1538-7445.sabcs19-p1-20-09 ◽

2020 ◽

Author(s):

Gabrielle Bergeron Giguère ◽

Brigitte Poirier ◽

Louise Provencher ◽

Dominique Boudreau ◽

Dominique Leblanc ◽

...

Keyword(s):

Single Dose ◽

Surgical Site Infection ◽

Prophylactic Antibiotic ◽

Site Infection

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A comparative study of open cholecystectomy and laparoscopic cholecystectomy in patients with cholelithiasis

International Surgery Journal ◽

10.18203/2349-2902.isj20175905 ◽

2017 ◽

Vol 5 (1) ◽

pp. 253 ◽

Cited By ~ 1

Author(s):

Pramod Singh ◽

Sumit Kumar Gupta ◽

Mukesh Kumar

Keyword(s):

Laparoscopic Cholecystectomy ◽

Surgical Site Infection ◽

Hospital Stay ◽

Open Cholecystectomy ◽

City Hospital ◽

Site Infection ◽

First Choice ◽

Duration Of Surgery ◽

Group A ◽

Group B

Background: Cholelithiasis is a major cause of morbidity among Indians with a female preponderance. Most of the cases of gallstones are asymptomatic. For a long time, open cholecystectomy (OC) used to be the surgical treatment for cholelithiasis. But with the advent of laparoscopic cholecystectomy (LC) there has been a gradual shift in the treatment with most surgeons preferring LC over OC. Apart from the benefits of decreased hospital stay, lesser postoperative pain and earlier return to normal activity LC are also cosmetically better as compared to OC. Longer operative time and increased incidence of biliary leakage are some pitfalls of LC in initial phase of surgical practice.Methods: A prospective study of 100 patients was carried out in the department of surgery in IQ city medical college and Durgapur city hospital, Durgapur between January 2017 and August 2017 with the aim of comparing open cholecystectomy with laparoscopic cholecystectomy. The patients were randomly assigned into two groups. Group A consisted of patients who underwent laparoscopic surgery while Group B patients underwent open surgery for cholelithiasis.Results: Duration of surgery was longer in OC than LC (72.4min versus 44.7min.). Mean duration of post-operative pain was 18.3hrs in group A as compared to mean duration of 30.7hrs in group B patients. The mean period of post-operative hospital stay was 1.8 days in group A and 4.8 days in group B. Post-operative resumption of normal diet was possible in 2.1 days in OC while it took lesser time (1.2 days) in LC. The rate of surgical site infection was higher in OC as compared to LC.Conclusions: Laparoscopic cholecystectomy can be recommended as first choice operative treatment for patients with cholelithiasis as it provides better cosmetic results, lesser pain, lesser post-operative hospital stay and fewer incidence of surgical site infection.

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

International Surgery Journal ◽

10.18203/2349-2902.isj20173894 ◽

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.

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Role of antibiotics in elective clean surgeries: limiting its use to single shot preoperative dose

International Surgery Journal ◽

10.18203/2349-2902.isj20201394 ◽

2020 ◽

Vol 7 (4) ◽

pp. 1186

Author(s):

P. T. Jamdade ◽

Meghraj J. Chawada ◽

Apurva Samant

Keyword(s):

Single Dose ◽

Antibiotic Therapy ◽

Surgical Site Infection ◽

Financial Burden ◽

Prophylactic Antibiotic ◽

Control Group ◽

Study Group ◽

Single Shot ◽

Site Infection ◽

Management Protocol

Background: Conventional antibiotic therapy during operation not only increases the financial burden on patient, not only increases chances of adverse reactions among them but also not effective in reducing the infection rate after surgery. Single dose prophylactic antibiotic or maximum 24 hours dosing during or before surgery was found to be equally effective. Objective was the to study utility of single shot antibiotic prophylaxis in patients undergoing surgeryMethods: This prospective study includes 100 clean elective surgical cases randomized to groups of 50 each. Single dose prophylactic antibiotic was given to cases in the study group and conventional antibiotic therapy was given to cases in the control group. Study group cases received Injection Ceftriaxone in the dose of 2 gm intravenously. This was given at induction or half an hour before the incision was given. Second dose was given if there was delay in starting the surgery for more than three hours. Dose of the antibiotic was adjusted for children, underweight and obese persons. For cases in the control group. Injection ceftriaxone 1 gm was given intravenously twice a day for three days. Surgical site infection incidence was recorded.Results: Both the groups were comparable for age, sex, diagnosis and hence the type of surgery performed. The incidence of fever, redness, swelling and wound discharge which are the signs of surgical site infection after surgery was not found to be statistically significantly different. Management protocol was also not significantly different after the surgery.Conclusions: Single shot antibiotic before surgery is equally effective in reducing the incidence of surgical site infections (SSIs) compared to conventional antibiotic therapy.

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