Key result
Minimal three-dose antibiotics show no significant difference in SSI rates versus routine 5-7 day therapy.
Why the study?
Excessive use of antibiotics in elective surgery increases resistance and medical costs, necessitating evaluation of minimal versus routine long-term antibiotic therapy.
Does minimal dose antibiotic prophylaxis prevent surgical site infection in patients undergoing elective surgery compared to routine long-term therapy?
RCT (n=250)
Randomly assigned
No
Does minimal dose antibiotic prophylaxis prevent surgical site infection in patients undergoing elective surgery compared to routine long-term therapy?
Minimal dose antibiotic prophylaxis is as effective as routine long-term therapy in preventing surgical site infections after elective surgery, potentially reducing hospital stay and costs.
Answers are grounded in this paper and cite their sources.
Supports minimal peri-operative prophylaxis alone in elective surgery; confirms similar efficacy to extended courses and aids stewardship.
Background: Antibacterial drugs are powerful agents to prevent infections but excess use of antibiotics led to increase of resistance towards the antibiotics used and thus has risen the expense in medical support.Methods: A total of 250 patients were included in the study. The patients were divided randomly into 2 groups, each containing 125 patients. Group I patients received. Three dosage of injectable ceftriaxone 1 gram intravenous peri-operatively, first dose twelve hour before surgery and second dose half hour before surgical incision and third dose twelve hours after surgery. Group II patients were given injectable ceftriaxone 1 gram intravenous peri-operatively, first dose twelve hour before surgery and second dose half hour before surgical incision and then followed by injection (conventional dose) ceftriaxone 1 gram/day I.V twice daily for the first 5-7 days post-operatively. Using Southampton wound grading system. The wound was inspected on the 3rd, 5th and 7th postoperative day days post operatively.Results: In group I, 15 (12%) cases had grade 2 SSI and in group II, 11 (8.8%) cases had grade 2 SSI. There was no statistical significance: p value is 0.83 and c2 0.048.Conclusions: A minimal dose antibiotic prophylaxis is equally efficient and has added advantage of reducing the duration of hospital stay and cost of medicines for the patients. Hence minimal dose antibiotic is better than a routine long term antibiotics therapy.
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Divan et al. (2021) conducted an RCT in Elective surgery (n=250). Minimal antibiotic therapy (Ceftriaxone) vs. Routine long term antibiotic therapy (Ceftriaxone 1 gram IV twice daily for 5-7 days post-operatively) was evaluated on Grade 2 Surgical Site Infection (SSI) assessed by Southampton wound grading system (p=0.83). Minimal three-dose peri-operative antibiotic prophylaxis resulted in a 12% surgical site infection rate compared to 8.8% with routine 5-7 day post-operative antibiotics, showing no significant difference.
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