Effect of Prophylactic Antibiotics in Orthopaedic Surgery

2021 ◽  
Vol 15 (11) ◽  
pp. 2969-2970
Author(s):  
Muhammad Siraj ◽  
Abbas Ali ◽  
Mudir Khan
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Orthopaedic Surgery ◽  
Prophylactic Antibiotics ◽  
Implant Removal ◽  
Diabetic Patients ◽  
Site Infection ◽  
Post Surgery ◽  
Group 2 ◽  
Group 1

Background: Orthopaedic surgeries require sensitive protocol for prevention of infection pre and post-surgery. Antibiotic-prophylaxis has been reported for reducing risk of infection in orthopaedic surgeries such as removal of implants. Aim: To assess the effect of prophylactic antibiotics in orthopaedic surgery. Study design: Retrospective study Place and duration of study: Dept. of Orthopaedics, Khyber Teaching Hospital, Peshawar from 1-1-2020 to 31-12- 2020. Methodology: One hundred and ten patients within 18-75 years were divided into two groups. Each group had 55 patients. Group 1 were given prophylactic antibiotics pre-operative as a single dose while group 2 were given only saline. All patients were admitted for removal of orthopaedic implants in foot, ankle or leg. Patients 30 days record was observed for any surgical-site infection. Results: The mean age of patient was 42.95±10.8 years. Group 1 and Group 2 had more males than females. There were 10.9% and 9.09% diabetic patients within group 1 and group 2. The 30 days assessment of post implant removal orthopaedic surgery showed a decrease of surgical-site infection in group 1. Surgical-site infection decreased by a rate of 5.4% among patients who were given cefazolin antibiotic. Conclusion: The effect of prophylactic antibiotic reduces chance of surgical-site infection in orthopaedic surgery. Keywords: Antibiotic-prophylaxis, Orthopaedic surgery, Implant-removal, Surgical-site infection

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 Perioperative Prophylactic Antibiotics in Orthopaedic Surgery

2013 ◽  
Vol 3 (1) ◽  
pp. 5-10
Author(s):  
Bikram Prasad Shrestha ◽  
Surya Raj Niraula ◽  
Parvin Nepal ◽  
Guru Prasad Khanal ◽  
Navin Karn ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Orthopaedic Surgery ◽  
Controlled Trial ◽  
Prophylactic Antibiotics ◽  
Drug Resistant ◽  
Site Infection ◽  
Oral Antibiotics ◽  
Randomized Controlled ◽  
Orthopaedic Patients ◽  
Significant Difference

Introduction: In our country, various institutes have different protocols for postoperative antibiotics. Many western literature have mentioned that administration of prophylactic antibiotics for longer than 24 hours has no advantage and may actually lead to superinfection with drug-resistant organisms. Because of environmental and theater condition most of the surgeon here are very reluctant to use prophylactic antibiotics for only 24 hours. The objective of the study was to find out the effect of duration of prophylactic antibiotics on the rate of surgical site infection in clean elective orthopaedic surgeries. Methods: This was a randomized controlled trial involving 207 clean elective orthopaedic patients undergoing surgery. The patients were divided into three groups which received intravenous prophylactic antibiotics for 24 hours, 48 hours and 48 hours followed by 7 days of oral antibiotics respectively. The patients were followed up for three months postoperatively. Result: There was no significant difference in the rate of surgical site infection among the three groups. Conclusion: We conclude that there is no benefit in prolonging prophylactic antibiotics beyond 24 hours. DOI: http://dx.doi.org/10.3126/noaj.v3i1.9318   Nepal Orthopedic Association Journal 2013 Vol.3(1): 5-10

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 AN UPDATED GUIDELINES ON POST-OPERATIVE WOUND MANAGEMENT

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Sangita Santosh Nimbalkar ◽  
Manish R. Malani
Keyword(s):  
Surgical Site Infection ◽  
Surgical Procedure ◽  
Wound Management ◽  
Site Infection ◽  
Nice Guidelines ◽  
Postoperative Wound ◽  
Post Surgery ◽  
Operative Care ◽  
Study Results ◽  
Group 1

Introduction: management and prevention of wounds after a surgical procedure, are important and debatable topics. Optimal adoption of guidelines for proper prevention and management of post-surgical wounds must be carried out by any surgeon or institute. Postoperative wound care is done by cleaning and dressing the wounds after the surgical procedure, preventing them from getting contaminated with the external surfaces or the microorganisms on the patient’s body. Surgical Site Infection (SSI) is the infection associated with healthcare in which the infection occurs in the wound after an invasive surgical procedure. A minimum of 5% of the patients who undergo surgical procedures will develop surgical site infections. This study draws the attention of the clinicians to a proper set of guidelines for post-operative care to minimize post-operative complications. Materials and Methods: this study is a Retrospective Cohort design. The study was considered 92 patients who had various types of surgery from during the period of 10 months. The patients who had intra-abdominal surgery are only included. The study divided 92 patients into 2 groups. In each group, 46 patients were assigned based on following NICE guidelines on postoperative wound management. Patients, for whom the NICE guidelines were followed properly at every aspect, were assigned to the first group (Group 1). Otherwise, the patients were assigned to the second group (Group 2). The study adopted a list comprising of NICE guidelines which are applicable to this study. The study assessment was done by observing the appearance of Surgical Site Infection among the patients, 3 to 7 days post-surgery. Results: it as found that 91.30% of the Group 1 patients showed significant improvement in terms of resolution while only 13.04% of the patients in improved significant without any surgical site infection (SSI). Conclusion: the study results show that the patients who were given post-operative care according to NICE guidelines had much lesser Surgical Site Infection (SSI) as compared to those who were not given post-operative care according to NICE guidelines. Keywords: surgical site infection, postoperative care, nice guidelines, wound management

scholarly journals Topical Rifamycin Prophylaxis in Gynecological and Obstetric Surgery

2021 ◽  
pp. 1-6
Author(s):  
Nahit Ata ◽  
Mehmet Kulhan ◽  
Nur Gozde Kulhan ◽  
Can Turkler ◽  
Ahmet Bilgi ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
First Generation ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Generation Cephalosporin ◽  
Site Infection ◽  
Group 2 ◽  
Obstetric Surgery ◽  
Systemic Antibiotics

OBJECTIVE: Antibiotic prophylaxis is one of the most important steps to reduce surgical site infections. First-generation cephalosporin (cefazolin) is used prophylactically in the majority of operations. Rifamycin is a broad-spectrum semisynthetic antibiotic that is bactericidal against gram (+) and gram (˗) microorganisms. To the best of our knowledge, there are no studies on the use of rifamycin in antibiotic prophylaxis. In this study, we aimed to analyze whether there is a difference between the use of only cefazolin and only rifamycin in terms of surgical site infections. STUDY DESIGN: One hundred patients were included in this case-control study during the last quarter period of 2017. These patients (n=100) were divided into two groups according to their antibiotic use; 50 patients who received only 1 g cefazolin constituted Group 1, 50 patients who received only 250 mg topical rifamycin over the incision line based on surgeon’s preference constituted Group 2. RESULTS: The use of prophylactic topical rifamycin reduced the incidence of wound infection. compared with cefazolin. Surgical site infection was detected in 5 (10%) of the patients who received cefazolin, whereas surgical site infection was not observed in patients who received rifamycin (p=0.022). CONCLUSIONS: The use of topical rifamycin is effective but does not imply that systemic antibiotics should replace prophylaxis. The use of rifamycin would aid in systemic antibiotic prophylaxis.

ROLE OF ANTIBIOTIC PROPHYLAXIS ON SURGICAL SITE INFECTION IN ELECTIVE ABDOMINAL SURGER

2021 ◽  
pp. 94-96
Author(s):  
Raj Kumar Negi ◽  
Ramesh Bharti ◽  
S.C Jaryal
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Prophylactic Antibiotics ◽  
Morbidity And Mortality ◽  
Healthcare Associated Infections ◽  
Site Infection ◽  
Coagulase Negative Staphylococci ◽  
Surgical Incision ◽  
Healthcare Associated

Surgical site infection (SSI) are healthcare-associated infections(HAIs) with signicant source of preventable morbidity and mortality. Prophylactic antibiotics are used most often to prevent infection of a surgical incision. S. aureus, coagulase-negative Staphylococci and Enterococci are the three organisms most commonly isolated from SSI

scholarly journals Antibiotic Prophylaxis in Elective Hand Surgery

2017 ◽  
Vol 45 (02) ◽  
pp. 089-093 ◽  
Author(s):  
Carolina Vasconcelos ◽  
Marta Serra ◽  
Rúben Nogueira ◽  
Leonor Carmo
Keyword(s):  
Retrospective Study ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Infection Rate ◽  
Prophylactic Antibiotic ◽  
Hand Surgery ◽  
Diabetic Patients ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Related Data

Purpose Antibiotic prophylaxis decreases the rate of surgical site infection in a broad spectrum of surgical procedures. However, in patients undergoing elective hand surgery, there is evidence of lower efficacy, and its use might be related to the development of antimicrobial resistance. The side effects and higher health-related costs must also be taken into consideration. Our aim was to assess the efficacy of antibiotic prophylaxis in these procedures. Material and methods A retrospective study was conducted including all patients who underwent clean, elective hand surgery lasting less than 30 minutes from January 1st 2014 to December 31st 2015 at our hospital. The demographic and surgery-related data were analyzed using the Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY, US) software, version 23.0. Results A total of 346 patients matched the study's inclusion criteria. The infection rate was of 1%, and it was not influenced by gender, age or diabetes mellitus. Antibiotic prophylaxis was administered in 52% of the cases, and it had no effect on the decrease in the infection rate, even in the group of diabetic patients. Conclusions Despite the inherent limitations of any retrospective study, our data analysis supports the fact that prophylactic antibiotic administration does not reduce the incidence of surgical site infection in clean, elective hand surgery that lasts less than 30 minutes, even in patients at risk.

scholarly journals Preoperative prophylactic antibiotics in orthopaedic surgery: duration of antibiotic administration

2013 ◽  
Vol 11 (1) ◽  
pp. 62-67
Author(s):  
BP Shrestha ◽  
SR Niraula ◽  
P Nepal ◽  
GP Khanal ◽  
N Karn ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Orthopaedic Surgery ◽  
Controlled Trial ◽  
Prophylactic Antibiotics ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Oral Antibiotics ◽  
Randomized Controlled ◽  
Orthopaedic Patients ◽  
Significant Difference

Background: Surgical site infection is one of the most dreaded complications faced by an orthopaedic surgeon. Objective: To find out the effect of duration of prophylactic antibiotics on the rate of surgical site infection in clean elective orthopaedic surgeries. Methods: We conducted a randomized controlled trial involving 207 clean elective orthopaedic patients undergoing surgery. The patients were divided into three groups which received intravenous prophylactic antibiotics for 24 hours, 48 hours and 48 hours followed by 7 days of oral antibiotics respectively. The patients were followed up for three months. Results: There was no significant difference in the rate of surgical site infection among the three groups. Conclusion: We conclude that there is no benefit in prolonging preoperative prophylactic antibiotics beyond 24 hours. Health Renaissance, January-April 2013; Vol. 11 No.1; 62-67 DOI: http://dx.doi.org/10.3126/hren.v11i1.7604

Antibiotic prophylaxis in surgery

2018 ◽  
pp. 169-178
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Risk Factors ◽  
Multidrug Resistance ◽  
Nosocomial Infection ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Prophylactic Antibiotics ◽  
Penicillin Allergy ◽  
Site Infection ◽  
Beta Lactams ◽  
Common Cause

Surgical site infection (SSI) is a common cause of nosocomial infection and prophylactic antibiotics are used to reduce post-operative wound infection. To identify risk factors for developing SSIs and to prescribe antibiotics for both prophylactic and therapeutic treatment according to local guidelines is very important. Beta lactams should be avoided in case of penicillin allergy and risk of multidrug resistance. C. diff infection should be considered with prolonged use of antibiotics.

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