Outcome of Evidence-based Allocation of Single-dose Antibiotic extended to Three-dose Antibiotic Prophylaxis in Surgical Site Infection

• Main Authors: Sangita D Jogdand Associate Professor, Raju K Shinde Professor and Head, Naman Chandrakar Senior Resident
• Format: Article
• Language: English
• Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2017-12-01
• Series: International Journal of Recent Surgical and Medical Sciences
• Subjects: dose policy; evidence-based randomization; surgical site infection
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.5005/jp-journals-10053-0046

Aim: To study the outcome of evidence-based allocation of single-dose antibiotic extended to three-dose antibiotics prophylaxis in surgical site infection (SSI). Materials and methods: A total of 183 clean surgical procedures in all age groups and of both genders with encountered comorbidities were included in the study. Surgical procedures like inguinal hernia, primary vaginal hydrocele, congenital hernia and hydrocele, fibroadenoma, and other surface swellings were targeted procedures. These procedures were of <1 hour duration and American Society of Anesthesiologists (ASA) grades I and II in study population. Ceftriaxone with sulbactam 1.5 gm was prophylactic antibiotic given 1 hour prior to incision. Excess local signs for inflammation were observed strictly for extension of antibiotics to three doses or multiple doses. Results: Success of evidence-based policy of randomization to single or three doses was 76.5% in all patients, and converting to three doses was 85.7%. Favorable outcome was seen in the patients with comorbidities—76.19% in hypertension, 57.14% in diabetes, and 28.57% in obesity. Only 14.3% of overall patients required extended multiple dose antibiotic therapy, which clearly projects that evidence-based policy implementation was effective in reducing number of doses. Conclusion: Evidence-based flexible antibiotic dose is effective in commonly performed procedures even with comorbidities. Flexibility depending on local signs to modify dose policy gives piece of mind with excellent outcome. Clinical significance: Adopting flexible antibiotic dosing reduces cost of antibiotics therapy with positive mindset for accepting reduced numbers of doses without affecting the outcome of surgical procedure.