Prophylactic antibiotics versus post- operative antibiotics in herniorraphy

Abstract

Postoperative surgical site infections are a major source of illness. Infection results in longer hospital stay and higher costs. Uses of preoperative antibiotics have been standardized and are being used routinely in most clinical surgeries and include controversial areas like breast surgery and herniorraphy. Objective of the study is to find out the benefit of prophylactic use of antibiotics in the management of herniorraphy.This project was carried out in a multispeciality tertiary care teaching hospital from 1 st -30 th April in 2002. Group 1 patients were treated prophylactically half an hour before surgery with single dose of I.V. antibiotics (injection. Ampicillin 1gm + injection. Gentamicin 80mg). Group 2 patients were treated post surgery with capsule. Ampicillin 500mg 4 times a day for 7 days and injection. Gentamicin twice a day for first 4 days. In case of group 1 patients only one out of 20 patients (5%) was infected. Whereas in-group 2 patients 5 out of 20 patients (25%) were infected. The cost of prophylactic antibiotic treatment was Rs. 25.56 per patient. The postoperative antibiotic treatment cost was Rs. 220.4 per patient. That means postoperative treatment is around 8.62 times costlier than prophylactic treatment. From this study it is evident that prophylactic (preoperative) treatment is better than postoperative treatment with antibiotics.