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

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.

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.

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

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

  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.

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

2017 ◽  
Vol 5 (1) ◽  
pp. 13
Author(s):  
Sagun Bahadur Thapa ◽  
Yeshwant Ramakrishna 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

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.

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.

Effective prevention of surgical site infection using a Centers for Disease Control and Prevention guideline–based antimicrobial prophylaxis in lumbar spine surgery

2007 ◽  
Vol 6 (4) ◽  
pp. 327-329 ◽  
Author(s):  
Masahiro Kanayama ◽  
Tomoyuki Hashimoto ◽  
Keiichi Shigenobu ◽  
Fumihiro Oha ◽  
Daisuke Togawa
Keyword(s):  
Single Dose ◽  
Lumbar Spine ◽  
Surgical Site Infection ◽  
Spine Surgery ◽  
Multiple Dose ◽  
Dose Group ◽  
Antimicrobial Prophylaxis ◽  
Lumbar Spine Surgery ◽  
Site Infection ◽  
Control And Prevention

Object Antimicrobial prophylaxis (AMP) reduces the rate of surgical site infection (SSI) in lumbar spine surgery, but a great deal of variation exists regarding the timing and duration of AMP. The authors had previously used prophylactic antibiotics for 5 to 7 postoperative days. Based on the Centers for Disease Control and Prevention (CDC) guideline, the AMP period was changed to the day of surgery only. In the current study, the authors compared the rate of SSI in lumbar spine surgeries between two different protocols of AMP. Methods Data from 1597 consecutive uninfected patients who had undergone lumbar spine surgery between January 1999 and September 2004 were reviewed. The pathophysiologies among these patients included disc herniation in 686, degenerative spondylolisthesis in 340, spinal stenosis in 259, failed lumbar surgeries in 73, degenerative scoliosis in 52, isthmic spondylolisthesis in 48, spinal trauma in 34, foraminal stenosis in 27, spinal tumor in 27, and miscellaneous in 51 patients. The rate of SSI was compared between the two AMP groups. There were 1133 patients in the multiple-dose group, and 464 patients in the single-dose group. The rate of instrumentation surgery was not statistically different between the multiple-dose group (43%) and the single-dose group (39%). The overall rate of SSI was 0.7%. The SSI rate was 0.8% in the multiple-dose group and 0.4% in the single-dose group; the difference between the two was not significant. Regarding the organisms of SSI, resistant strains of bacteria were cultured in five (83.3%) of six patients in the multiple-dose group, whereas none was cultured in the single-dose group. Conclusions Data in the current study did not demonstrate a difference in the rate of SSI between the two different AMP protocols. Based on the CDC guideline, a single dose of AMP was proven to be efficacious for the prevention of SSI in lumbar spine surgeries. A shorter duration of first-generation cephalosporin use may effectively prevent the emergence of antibiotic-resistant bacterial infection.

scholarly journals Role of hyperoxygenation on surgical site wound infection: a randomised case control study

2019 ◽  
Vol 6 (8) ◽  
pp. 2927
Author(s):  
Samba Siva Rao G. ◽  
Kiran Kumar Suggala
Keyword(s):  
Surgical Site Infection ◽  
Case Control Study ◽  
Elective Surgery ◽  
Randomized Study ◽  
Control Group ◽  
Site Infection ◽  
Medical College ◽  
Induction Of Anaesthesia ◽  
Control Study

Background: The aim of this study was to assess the influence of hyperoxygenation on surgical site wound infections.Methods: Using prospective randomized study, conducted from January 2018 to December 2018 at Mamata Medical College and General hospital, Khammam. This study includes 100 patients who were going for elective surgery at various divisions of Department of surgery. Patients were assigned randomly to an oxygen/air mixture with a faction of inspiration (FiO2) of 30% (n=50) and 60% (n=50). Administration was started after induction of anaesthesia and maintained for 3hours after surgery.Results: Surgical site infection was recorded in 5 patients (2 of 50, 10%) in the hyperoxygenation group and 11 patients (11 of 50, 22%) in the control group (p<0.05). Time of hospitalization was 5±3 days in the hyperoxygenation group and 9±4 days in the control group (p<0.05).Conclusions: Hyperoxygenation was associated with a reduction in surgical site infection. It also decreases the duration of hospital stay and decreases economic burden.

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.

scholarly journals A Prospective Randomized Study to Assess the Optimal Duration of Intravenous Antimicrobial Prophylaxis in Elective Gastric Cancer Surgery

2012 ◽  
Vol 97 (2) ◽  
pp. 169-176 ◽  
Author(s):  
Norihiro Haga ◽  
Hideyuki Ishida ◽  
Toru Ishiguro ◽  
Kensuke Kumamoto ◽  
Keiichiro Ishibashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Single Dose ◽  
Multiple Dose ◽  
Dose Group ◽  
Antimicrobial Prophylaxis ◽  
Randomized Study ◽  
Surgical Site Infections ◽  
Cancer Surgery ◽  
Site Infection ◽  
Gastric Cancer Surgery

Abstract The duration of antimicrobial prophylaxis in gastric cancer surgery is not yet established. This prospective randomized study was performed to confirm the noninferiority of single-dose versus multiple-dose antimicrobial prophylaxis in terms of the incidence of surgical-site infection in gastric cancer surgery. Three hundred twenty-five patients undergoing elective resection for gastric cancer were randomized to receive only single-dose cefazolin (1 g) during surgery (single-dose group) or an additional 5 doses every 12 hours postoperatively (multiple-dose group). The overall incidence of surgical-site infections was 9.1% in the single-dose group and 6.2% in the multiple-dose group [difference (95% confidence interval): −2.9% (−5.9%–0.0%)]. Multivariate logistic regression analysis identified blood loss, being overweight, and advanced age as significant independent risk factors for surgical-site infection. Single-dose antimicrobial prophylaxis seemed to be acceptable, and choosing multiple-dose prophylaxis may have little impact on the prevention of surgical-site infections in elective gastric cancer surgery.

scholarly journals Bile spillage and bacterobilia as risk factors for surgical site infection after laparoscopic cholecystectomy: a prospective study at tertiary care hospital

2019 ◽  
Vol 6 (9) ◽  
pp. 3223
Author(s):  
Rekha Porwal ◽  
Aakanksha Soni ◽  
Amit Singh ◽  
Shruti K. Somani ◽  
Poornima Sagar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Site Infection ◽  
Tertiary Care ◽  
Care Hospital ◽  
Site Infection ◽  
Exclusion Criteria ◽  
Medical College ◽  
Study Population ◽  
A Prospective Study ◽  
Bile Spillage

Background: Surgical site infection (SSIs), a significant postoperative complication, can lead to considerable patient’s morbidity and mortality.Methods: The study was conducted in the Department of Surgery, J.L.N. Medical College and Hospitals, Ajmer from January 2017 to September 2018. The study population constituted cases of cholelithiasis diagnosed by ultrasonography that underwent laparoscopic cholecystectomy and fulfilling the inclusion and exclusion criteria. Surgical site infection was graded according to Southampton grading system.Results: The overall frequency of SSI infection in laparoscopic cholecystectomy was 6%. The occurrence of surgical site infection in patients with bacterobilia was 14.28% which was found to be statistically significant. The SSIs in patients with gall bladder content spillage was found to be statistically insignificant.Conclusions: The frequency of SSI was more in patients with bacterobilia. The gallbladder content spillage does not lead to an increased occurrence of SSI. 

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.

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