Topical Rifamycin Prophylaxis in Gynecological and Obstetric Surgery

Nahit Ata,Can Turkler,Nur Gozde Kulhan,Cetin Celik,Mehmet Kulhan,Ahmet Bilgi

doi:10.21613/gorm.2021.1193

Abstract

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.

Highlights

Surgical site infections (SSI) continue to be a very important and serious problem of modern surgery despite asepsis and antisepsis applications, sterilization methods, developments in operating room conditions, and prophylactic antibiotics
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)

Summary

Introduction

Surgical site infections (SSI) continue to be a very important and serious problem of modern surgery despite asepsis and antisepsis applications, sterilization methods, developments in operating room conditions, and prophylactic antibiotics. Infections observed at the incision site and in the organs or areas where surgical intervention was performed within the Erzincan University Medical Faculty Gynaecology and Obstetrics Department Erzincan, Turkey. Selcuk University Medical Faculty Gynaecology and Obstetrics Department Konya, Turkey. Konya Education Research Hospital Gynaecology and Obstetrics Department Konya, Turkey. Quick Response Code: Access this article online. Gynecol Obstet Reprod Med. 2021;27 Articles in Press) first 30 days following the operation are called SSI [1]. Standard definitions were introduced by the Centers for Disease Control and Prevention (CDC) in 1992 and 1998 to diagnose SSI according to certain criteria and to reach more accurate statistical data. According to the standard definitions introduced by this center, SSIs are divided into two groups as incisional and organ/area infections. Incisional wound infections are classified as superficial and deep incisional wound infections [2,3]

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