Dose Of Preoperative Antibiotics Research Articles

Antibiotics for surgical site infections in patients undergoing orthognathic surgery.

PubMed, Embase, Web of Science and Scopus. Randomized Controlled Trials (RCTs) for patients undergoing orthognathic surgery of any type, which evaluated surgical site infections (SSI) in either: long-term (at least 2 days) post-surgical antibiotic dosing versus short term (one day) post-surgical dosing for the same drug; or Orthognathic surgery patients administered a post-surgical single-day antibiotic versus a singular pre-operative dosing of any antibiotic in the post-surgical phase. Singe-arm studies, retrospective studies, unpublished data, studies which were not peer-reviewed, editorials and trials not dealing with patients undergoing orthognathic surgery specifically were not included. Data for the publication year, primary author name, location of the study, antibiotic type, antibiotic protocol with its type, dosing and timing, sample size, protocol of the control group, male gender, age, diagnosis and rates of SSIs were extracted from the included studies. Pooled rates of SSIs were utilized to produce risk ratio (RR). A total of eleven RCTs met the inclusion criteria. As per the meta-analysis, post-orthognathic surgery SSI risk was reduced significantly as a result of long-term prophylactic antibiotic usage when compared to short-term utilization. Further, the meta-analysis demonstrated that there was a significant reduction of SSI risk in patients on a single day prophylactic antibiotic regimen in comparison to those on a single preoperative antibiotic dose. The study observed that long-term (2-7 days) prophylactic antibiotics reduce SSI risk when compared to antibiotic administration over a single day. In turn, it was also found that the latter was of greater benefit over a pre-operative single antibiotic dosage.

Antibiotic administration for open reduction internal fixation of closed ankle fractures: Is one preoperative dose enough?

Although preoperative antibiotics are used routinely in ankle fracture surgery, there is considerable variability in postoperative antibiotic dosing regimens amongst surgeons. The aim of this study is to compare the rate of surgical site infection (SSI) in patients receiving one dose of preoperative antibiotics to patients who received more than one dose of antibiotics. A single-center Level I Trauma Center retrospective review of patients with isolated closed ankle fractures who underwent open reduction internal fixation over a 10-year period was performed. Demographics data and risk factors were obtained from the electronic medical record. SSI was detected using a text-mining algorithm on all postoperative clinic notes. Factors associated with the development of SSI or increased antibiotic dosing were evaluated. Eight-hundred and twenty-six patients were included in the analysis. There was no correlation between infection rate and any of the potential risk factors evaluated. Two-hundred and ninety-two patients received only one dose of antibiotics preoperatively and 534 patients received more than one antibiotic dose. The rate of SSI was not significantly different between the single-dose cohort (5.8 %) and the multi-dose cohort (3.9 %) (p=0.215). Routine use of postoperative antibiotics in open reduction internal fixation of closed ankle fractures did not decrease the rate of SSI, regardless of associated comorbidities. Level of evidence: Level III (therapeutic retrospective cohort study)

Frequency of surgical site infection after single dose of preoperative antibiotics in children with uncomplicated acute appendicitis: a cross-sectional study

Background: Hyperaemic suppurative appendicitis, or uncomplicated appendicitis, often requires an appendectomy. Surgical Site Infection (SSI) is common post-surgery, and prophylactic studies show ceftriaxone and metronidazole effectively protect against most causative organisms. Methods: Ninety patients were included through non-probability convenience sampling. Acute appendicitis was diagnosed using the Alvarado score, with surgery for scores of 7 or higher. A single preoperative dose of ceftriaxone and metronidazole was administered. Follow-up visits included stitch removal on the seventh postoperative day and monitoring up to the tenth postoperative day using the Southampton criteria for wound infection. Results: Of the 90 patients, 64 (71.1%) were male and 26 (28.9%) were female. Fifty (55.6%) scored 7-8 on the Alvarado score, and 40 (44.4%) scored 9-10. Using the Southampton criteria, 5 (5.6%) developed grade I SSI. Infection rates showed no significant difference between male (3.1%) and female (11.5%) patients (p value >0.05) or by Alvarado score and symptom duration. No cases of SSI beyond grade II were observed. Conclusions: Administering a single preoperative antibiotic dose effectively minimizes surgical site infection in children with uncomplicated acute appendicitis, demonstrating clear management advantages.

Optimizing preoperative antibiotic use through improved penicillin allergy documentation.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Penicillin allergy documentation in the electronic health record (EHR) lacks detail with regard to type of reaction, history of reaction, and other tolerated β-lactams. Because of concern for penicillin allergy cross-reactivity with cefazolin, patients with a reported penicillin allergy are frequently prescribed suboptimal preoperative antibiotics, which have been associated with negative patient outcomes, including increased risk of surgical site infection. The purpose of this study was to increase preoperative use of cefazolin via improvement to the documentation of penicillin allergies in the EHR. This single-center, quasi-experimental quality improvement study compared patients with a self-reported penicillin allergy admitted for select elective surgeries before and after implementation of a penicillin allergy questionnaire. The primary outcome was receipt of cefazolin for surgical prophylaxis. Secondary outcomes were the proportion of patients with detailed penicillin allergy documentation, the proportion of patients with surgical site infections occurring within 30 days of surgery, and the proportion of patients who received the full antibiotic dose before the first surgical incision. A total of 100 patients were included in the preintervention group, while 85 patients were included in the postintervention group. Cefazolin use was higher in the postintervention group (13.0% vs 41.2%; P < 0.001). The postintervention group also had a larger proportion of patients with detailed allergy documentation (2.0% vs 50.6%; P < 0.001) and who received the full preoperative antibiotic dose before the first incision (25.0% vs 48.2%; P = 0.001). There was no statistical difference between the groups in the incidence of surgical site infection at 30 days after surgery (3.0% vs 1.2%; P = 0.63). Preoperative cefazolin use was higher in patients with a reported penicillin allergy after implementation of a penicillin allergy questionnaire and EHR documentation tool.

Adherence to Antimicrobial Prophylaxis Guidelines in Endourologic Procedures: Frequency and Related Outcomes.

Background: Surgical antimicrobial prophylaxis (SAP), when used appropriately based on evidence-based guidelines, can reduce the rate of infectious complications following endourologic procedures without compromising patient outcomes. Objectives: To investigate the appropriateness of the current SAP used in endourologic surgeries based on international guidelines and report their associated outcomes (urinary tract infection [UTI] and blood stream infection [BSI]). Design: Prospective cross-sectional study. Methodology: The medical records of patients undergoing endourologic procedures were reviewed to assess healthcare providers' adherence to international guideline recommendations. Assessed parameters included indication, duration, choice, and dose of the antibiotics used in endourologic procedures in two medical centers in Amman/Jordan. Furthermore, patients were asked to conduct laboratory urine tests to determine the rate of infectious complications within one month post-procedure. Results: Three hundred and sixty-one patients were recruited for the study. The adherence rates to guidelines regarding indication, choice, and dose of pre-operative antibiotics were 90.3%, 2.8%, and 77.8%, respectively. The duration was concordant with guidelines in only 3.4% of participants. A total of 41.8% of patients completed follow-up. Among those, 4.6% developed bacterial UTIs, and 0.7% developed BSI. Conclusion: Adherence to SAP guidelines in endourologic procedures was far from optimal. Primary deviations in the implementation of guidelines' recommendations were pinpointed. These results are crucial for planning interventions that optimize SAP utilization.

The Impact of Redosing Antibiotics for Pediatric Patients Undergoing Appendectomy for Complicated Appendicitis.

Currently, there is no universally accepted, standardized protocol for pre-operative antibiotic administration in the setting of appendectomy for complicated appendicitis among pediatric patients. Strategies to mitigate surgical site infections (SSIs) must be balanced with optimal antibiotic use and exposure. We conducted a retrospective chart review to compare outcomes between patients treated pre-operatively with a single pre-operative dose of antibiotics with those who received additional antibiotics prior to laparoscopic appendectomy for complicated appendicitis between 2020 and 2022. Of 124 pediatric patients, 18% received an additional dose of pre-operative antibiotics after initial treatment dose. Surgical site infection rates between the two groups were not statistically significant (P-value = .352), thereby suggesting that redosing antibiotics closer to the time of incision may not impact SSI rates. Additional studies are necessary to make clinical recommendations.

Surgical Site Infections in Single-dose versus Multiple-dose Broad-spectrum Intravenous Antibiotic Prophylaxis in Clean Surgeries: A Quasi-experimental Study

Introduction: Surgical Site Infections (SSIs) constitute a prevalent nosocomial concern among surgical patients. The incidence of SSIs typically ranges from 1-2% in the context of clean surgeries, irrespective of the use of antibiotic prophylaxis. Frequently, a single preoperative dose of antibiotics administered up to 60 minutes before surgery suffices. Aim: To compare the rates of postoperative infections following a single preoperative dose of prophylactic antibiotics with those receiving multiple postoperative doses. Materials and Methods: This quasi-experimental study was conducted at the Surgery Department of Kumareshwara Hospital in Bagalkot, Karnataka, India. Participants included individuals aged over 18 years undergoing elective clean surgeries, with their informed consent. Patients with co-morbidities or pre-existing infections at the surgical site were excluded from the study. A total of 161 cases were enrolled, divided into two groups: Group A (single dose of broad-spectrum i.v. antibiotic with 70 patients) and Group B (multiple doses of the same broad-spectrum antibiotic with 91 patients). Independent parameters of outcome variables were analysed using the Chi-square test and Student’s t-test. Results: The mean age of study participants was 41.25±13.47 years. The incidence of SSI in Group A was 1.42%, while in Group B, it was 2.20%. The mean duration of hospital stay was shorter in Group A (6.11±3.87 days) compared to Group B (7.60±4.08 days). Conclusion: In conclusion, the study suggests that the incidence of SSIs in both groups is similar and statistically insignificant for clean surgeries. Importantly, the hospital stay was shorter in the group receiving a single preoperative dose of antibiotics compared to multiple doses of antibiotics.

Impact of long-term vs. short-term and single day vs. single dose of antibiotic prophylaxis in reducing infection rates after orthognathic surgery: a systematic review and meta-analysis.

This review was designed to examine the effect of long-term (≥2 days) vs. short-term (1 day) and single-day vs. single preoperative doses of antibiotic prophylaxis on surgical site infection (SSI) rates after orthognathic surgery. PubMed, Web of Science, Embase, and Scopus were searched for randomized controlled trials (RCTs) without any date or language restriction till 1st September 2023. SSI rates were pooled to generate risk ratio (RR). Eight RCTs comparing long-term vs. short-term and three RCTs comparing single day vs. single preoperative dose of antibiotic prophylaxis were included. Meta-analysis showed that the use of long-term antibiotic prophylaxis significantly reduced the risk of SSI after orthognathic surgery as compared to short-term antibiotics [RR:0.42 (95% CI: 0.23, 0.76) I2=0%]. Meta-analysis also noted that patients receiving a single day of antibiotic prophylaxis had significantly reduced risk of SSI as compared to those receiving only a preoperative single dose of antibiotics [RR:0.28 (95%: 0.09, 0.82) I2=0%]. Evidence from a limited number of RCTs with moderate to high risk of bias shows that two to seven days of long-term antibiotic prophylaxis reduces the risk of SSI as compared to single-day antibiotic therapy. Also, a single day of antibiotics may be more beneficial than a single pre-operative dose of antibiotic.

Compliance with Antimicrobial Prophylaxis Guidelines in Endourological Procedures: Frequency and Related Outcomes

Introduction: Surgical antimicrobial prophylaxis (SAP), when used appropriately based on evidence-based guidelines, reduces the rate of infectious complications following endourological procedures without compromising patient outcomes.&#x0D; Aims: to audit the appropriateness of the current SAP used in endourological surgeries based on international guidelines and report their associated outcomes (urinary tract infection (UTI) and bloodstream infection (BSI)).&#x0D; Methodology: The adherence to international guidelines recommendations; AUA 2019 and EAU 2020, regarding indication, duration, choice, and dose of the antibiotics used in endourological procedures were assessed in two medical centers in Amman/Jordan. Also, patients were asked to conduct laboratory urine test to determine the rate of infectious complications within one-month post-procedure.&#x0D; Results: Three hundred sixty-one patients were recruited for the study. The adherence rate to guidelines regarding indication, choice, and dose of pre-operative antibiotics was 90.3%, 2.8%, and 77.8% respectively. The duration was concordant with guidelines in only 3.4% of participants. A total of 41.8% of patients completed follow-up. Among those, 4.6% developed bacterial UTIs, and 0.7% developed BSI.&#x0D; Conclusion: Adherence to SAP guidelines in endourological procedures is far from optimal, especially by an inappropriate selection of broad-spectrum antibiotics as the agent of choice and prolonged use of antibiotics after the procedure in the absence of any documented infectious complication.

One week pre-operative oral antibiotics for percutaneous nephrolithotomy reduce risk of infection: a systematic review and meta-analysis.

The aim of this meta-analysis is to assess the efficacy of extended dose of preoperative antibiotics to reduce infectious risk in patients undergoing percutaneous nephrolithotomy (PCNL). A literature search for prospective case-control studies or randomized controlled trials was done. PICO framework was used. adult patients that underwent to PCNL; Intervention: extended dose preoperative antibiotic prophylaxis before PCNL; Control: short dose preoperative antibiotic prophylaxis before PCNL; and Outcome: systemic inflammatory response syndrome (SIRS) or sepsis, fever after PCNL and positive intraoperative urine and stone culture. This meta-analysis was registered in PROSPERO database under the number: CRD42022359589. Three RCT and two prospective studies (475 patients) were included. SIRS/sepsis outcome was retrieved from all studies included. Seven days preoperative oral antibiotics for PCNL was a protective factor for developing SIRS/sepsis (OR 0.366, 95% CI 0.234 - 0.527, p < 0.001). There was no statistical association between seven-day use of antibiotics and fever (OR 0.592, 95% CI 0.147 - 2.388, p = 0.462). Patients who received seven days preoperative antibiotics had lower positive intraoperative urine culture (OR 0.284, 95% CI 0.120 - 0.674, p = 0.004) and stone culture (OR 0.351, 95% CI 0.185 - 0.663, p = 0.001) than the control group. one week of prophylactic oral antibiotics based on local bacterial sensitivity pattern plus a dose of intravenous antibiotics at the time of surgery in patients undergoing PCNL reduces the risk of infection.

997 Audit Examining the Treatment of Patients Who Developed Post Operative Complications Following Appendicectomy

Abstract Aim To identify trends in management of patients with post operative complications following appendicectomy in a district general hospital. Method The coding department identified patients who were admitted with appendicitis in the previous year and those who developed post operative complications. Data was gathered retrospectively from these patients using their online records. Results Coding identified 270 patients that were admitted between 22/10/20–29/10/21 with appendicitis. 19 patients had post operative complications. 9 had intra-abdominal collections, 5 had wound infections/collections, 3 had an ileus. 15/19 patients with complications underwent imaging, 8 had CT scans and 7 had US scans. Patients waited a mean of 0.4 days between presentation and imaging. Patients waited a mean of 2.2 and median of 0 days between imaging and appendicectomy. 12 patients had complicated appendicitis, 6 had simple appendicitis and 1 had a normal appendix. 16 patients had antibiotics pre and post operatively, 3 did not. The mean length of stay was 5.6 days for patients with complications, compared to a mean length of stay of 3.9 days for all patients with appendicitis. Conclusions Early identification and management of appendicitis reduces morbidity, and our centre appears to have lower than average complication rates. The patients who did develop complications, were generally imaged and operated on efficiently An area of improvement is ensuring all patients undergoing appendicectomies are given at least one preoperative dose of antibiotics and up to 3–5 days post operatively if complicated as per WSES guidelines. We aim to re-audit this after an education drive within our department.

Comparison of three antibiotic protocols for prevention of infection in dental implant surgery: A randomized clinical trial

SummeryThis study aimed to compare the rate of post-surgical infection following single-dose antibiotic prophylaxis with or without post-surgical antibiotics versus post-surgical administration of antibiotics alone. The study consisted of three groups; Group 1 received single-dose antibiotic prophylaxis orally (2 g amoxicillin 1 h before surgery). Group 2 received one dose of prophylactic antibiotic (2 g amoxicillin 1 h before surgery) with additional doses after surgery (500 mg amoxicillin, q8h for 5 days). Group 3 received post-surgical antibiotics alone (500 mg amoxicillin, q8h for 5 days). 450 patients were enrolled. Post-surgical infection was seen in 9 patients of group 1, 11 patients of group 2, and 7 patients of group 3. There was no significant difference in the rate of postoperative infection among the study groups (p value = 0.62). The number of failed implants was 2 in group 2, and 1 in group 3. Subgroup analysis showed no significant difference in infection rates among the three groups regarding concomitant guided bone regeneration. However, there was a significant difference in the rate of post-surgical infection between smokers and non-smokers (p < 0.001). Within the limitations of the study, it seems that a single preoperative dose of antibiotics is sufficient for reducing surgical site infections, adequately and should be preferred after implant placement whenever appropriate.

Comparative Evaluation of the Influence of Single Preoperative Antibiotic Dose of Amoxicillin (1gm) and Postoperative Antibiotic Dose of Amoxicillin Drug (500mg) Regimen on Postoperative Outcome and Implant Stability in Single Tooth Dental Implant Surgery: Randomized Controlled Trial

Aims: A single blinded randomized controlled trial was conducted to test the efficiency of two antibiotic regimens on post operative outcome and implant stability in single tooth dental implant to overcome the increasing drug resistance due to over prescription of medicines and side effects of the same.&#x0D; Methodology: 20 participants needing single tooth dental implant were enrolled based on inclusion and exclusion criteria. The participants were randomly assigned into groups. 10 participants in group 1 received only a single preoperative dosage of amoxicillin 1gm which was followed by paracetamol. In group 2, 500mg amoxicillin was given postoperatively followed by a three times a day for 3 days regimen. The postoperative outcome was evaluated based on swelling, post-operative bruising, suppuration and wound dehiscence noticed on 2nd and 7th day postoperatively. ISQ (implant stability quotient) was checked 3 months post implant placement as osseointergration is the main goal of implant placement.&#x0D; Results: Post-operative bruising, suppuration and wound dehiscence were not noticed in the entire study due to sterile environment during implant placement. When swelling was compared between group 1 and 2 it was statistically insignificant on day 2 (Mann Whitney u=40.00, p=0.383) and day 7 (Mann Whitney u=50.00, p=01.00). ISQ (IMPLANT STABILITY QUOTIENT) score in group 1&amp;2 also showed statistically insignificant results (t=0.00, p=1.00) Which states that there was no significant difference in the stability of implants when single preoperative antibiotic dose of amoxicillin(1gm) and postoperative antibiotic dose of amoxicillin drug(500mg) regimen 3 times a day for 3 days was given.&#x0D; Conclusion: this study shows that in healthy individual, when single implant is placed in proper sterile environment with routine dental hygiene such as brushing and chlorhexidine mouthwash use by patient, single preoperative dose of amoxicillin 1gm is sufficient for the success of implant. However, considering the limitations of the study, further work is necessary to validate reliability.&#x0D; No adverse effects were observed in the study&#x0D; Funding: NIL&#x0D; Reg no:DYPDCH/EC/648/12/2021

Do Preoperative Prophylactic Antibiotics Reduce Surgical Site Infection Following Wire-Localized Lumpectomy? A Single-Blind Randomized Clinical Trial.

Data on the benefits of preoperative prophylactic antibiotics for breast surgery are conflicting, and there is no specific guideline for their use in wire-localized lumpectomy. This is a proof-of-concept, single-blind randomized controlled trial carried out from April 2018 to June 2019 at the Centre des Maladies du Sein du CHU de Québec - Université Laval. The objectives were to determine whether a single dose of preoperative antibiotics reduces surgical site infection (SSI) after wire-localized lumpectomy and to identify the risk factors for SSI. The patients were randomized to receive preoperative prophylactic antibiotics or not. SSI was defined by positive breast wound cultures, abscess drainage, and/or antibiotics given for clinical signs of breast infection within 30 days of the operation. This study was registered with ClinicalTrials.gov, NCT04818931. A total of 330 patients were enrolled. Eighteen patients were excluded. The SSI rate was 3.1% (5/160) in the antibiotic group versus 5.9% (9/152) in the control group (p = 0.28). Only obesity was a significant risk factor for SSI. All cases of SSI were treated routinely with antibiotics; one patient required wound re-opening. None of the SSIs delayed the adjuvant treatment. Preoperative antibiotic prophylaxis does not significantly decrease the occurrence of breast SSI. It is safe to omit prophylactic antibiotics for a wire-localized lumpectomy. This could also decrease the treatment costs and avoid unnecessary side effects.

Antibiotic prescribing practices in general surgery: a mixed methods quality improvement project

SummaryBackgroundA single pre-operative antibiotic dose provides optimal prophylaxis against surgical site infection (SSI), but significant variability persists in adherence to prophylaxis guidelines. We describe a quality improvement project aiming to improve guideline-driven antibiotic prescribing within surgical teams at a tertiary hospital.MethodsFace-to-face interviews with surgical teams and anonymous surveys of senior surgeons and anaesthetists were used to collect qualitative data on the perceptions and attitudes of prescribers. This informed intervention development, including a daily ward-round checklist using the acronymous ‘ABBDDOMM’, from A (antibiotics) to M (microbiology), combined with education and heightened guideline accessibility. A first audit cycle was performed for patients undergoing intra-abdominal surgery during a two-month period (cycle one). Post-implementation data were collected 12 months later (cycle two).FindingsInterviews provided insight into common themes and barriers surrounding antibiotic prescribing, whilst surveys explored future solutions to these barriers. In cycle one, 100/205 (48.8%) patients received extended antibiotics beyond the single-dose prophylaxis. Following intervention, only 41/138 (29.7%) patients received extended antibiotic courses, demonstrating a 21.5% reduction in prolonged antibiotics (P<0.0005). In cycle one, 107/205 patients (52.2%) received antibiotics compliant with Trust Guidelines, compared to 80/138 (58.0%) in cycle two.ConclusionOur proposed checklist, alongside antimicrobial stewardship education, prompts daily review of important patient parameters and results to significantly reduce inappropriate post-operative antibiotic prescribing. Promoting the sustained use of similar checklists by junior doctors and focusing on measures to improve uptake of pre-operative induction antibiotic guidelines is required to achieve further benefits.

What Is the Proper Antibiotic Prophylaxis Regimen for Dental Implant Placement?

What Is the Proper Antibiotic Prophylaxis Regimen for Dental Implant Placement?

Is a single dose of preoperative antibiotic therapy effective for patients treated with megaendoprosthesis after metastatic bone tumour resection?

All patients who underwent primary MPR in MBD were included in this prospective study. All penicillin-sensitive patients received one dose of cefuroxime 1.5gm intravenous at induction. In penicillin-allergic patients, teicoplanin 1.2gm and ciprofloxacin 500mg intravenous was administered. The patients were followed up in the wound clinic and the specialist MBD clinic at 2weeks, 3months, 6months and then annually. Data collected included demographics, primary tumours, surgical procedures, complications and duration of follow-up. All calculations were performed using SPSS® 25(IBM, USA). A p value ≤ 0.05 was considered to be significant. There were 51 patients with a mean age of 65.4years. Procedures included proximal femoral replacement (35), distal femoral replacement (7), proximal humeral replacement (4), distal humeral replacement (3) and total femoral replacement (2). Thirty-seven patients received cefuroxime, and fourteen patients received teicoplanin and ciprofloxacin at induction of anaesthesia. The deep infection rate was 1.9%. Thirty-seven patients died with a median survival of 10months (1 to 51months). Mean follow-up was 18.9months (1 to 70months). Single dose of preoperative antibiotics at anaesthetic induction seems to be safe and effective for preoperative prophylaxis in orthopaedic oncology.

Effectiveness of single application alcohol based antiseptic solution in preventing surgical site infection

Background: Surgical site infections are the most commonly encountered problem in all surgical procedure. The main aim of the study is finding out the effectiveness of single application alcohol based antiseptic solution during preoperative preparation to reduce the surgical site infections. Materials and Methods: It is a prospective study of patients who underwent major and minor procedure in the duration of August 2019 - December 2019. The primary outcome of the study was evaluated on the basis of type of procedure, days of hospital stay, postoperative complications like seroma and pus discharge. Results: Out of two hundred patients included in this study, 100 patients underwent minor procedure and the other 100 underwent major procedure. Age distribution for minor cases less than 25 is 3, 26-50 is 42 and 51-75 is 103 with mean ± SD is 50.41± 14.25 and for major cases less than 25 is 1, 26-50 is 51, 51-75 is 48 with mean ± SD is 50.87± 13.59. Sex distribution of minor cases male - 48 & female -52, major cases with distribution of male -45 and female -55. Hospitalisation of all minor cases are less than 1 day with mean value of 1 and major cases less than 1 day are 4, 2-3 days are 86 and more than 3 days are 10 with mean value of 2.3. Each patient was carefully monitored for the period of 30 days from the day of surgery and the complications, if any was treated accordingly. Out of 100 minor cases, seroma formation was noted in 3 patients and pus discharge in 4 patients. Collections were evacuated thorough wound wash and saline dressing were done (no antibiotics were given for these cases both preoperative as well as postoperative period).Whereas, Out of 100 major cases (single dose of preoperative antibiotics are given) seroma formation were noted in 7 patients, seroma collections were evacuated, thorough wound wash and saline dressing were done (no antibiotics were given for these cases), Pus discharge was found in 7 patients, among them 4 were treated with I V Antibiotics for 5 days according to pus culture and sensitivity report. Conclusion: The 200 patients who underwent procedure with single application of alcohol based antiseptic solution (2% chlorhexidine) for pre-operative preparation, was found to be effective against surgical site infections.

A comparative study between a single dose pre-induction antibiotic versus continuous antibiotics to prevent urinary tract infection during ureteroscopy

Background and objective: This study aimed to evaluate the effect of adding postoperative antibiotics in reducing the incidence of symptomatic urinary tract infections following ureteroscopic stone treatment beyond the recommended preoperative dose. Methods: This prospective comparative study was conducted between March and November 2017. A total of 80 patients with preoperative negative urine cultures who underwent ureteroscopy were randomly allocated. All the patients received a single dose antibiotic before the induction of anesthesia, and a group of them also received postoperative antibiotics. The rate of symptomatic urinary tract infection was compared between the patients who received only preoperative antibiotics (group 1) and those who received pre- and postoperative antibiotics (group 2). Results: Eighty patients underwent ureteroscopy for stone treatment. The time to follow up was 4±2 weeks from ureteroscopy. Eleven (13.8%) patients in total developed urinary tract infections postoperatively, including five (12.5%) from group 1 and six (15%) from group 2, P = 0.74. In group 1, four patients presented with cystitis and one with sepsis; those patients with infections in group 2 presented with pyelonephritis (n=2) and cystitis (n=4). Risk factors such as preoperative stenting, nephrostomy tubes, and Foleys catheters did not differ between groups. Conclusion: The postoperative symptomatic urinary tract infection rate in this study (13.8%) is in agreement with previous reports. This study suggests that a single preoperative dose of antibiotics is sufficient, and additional postoperative antibiotics do not decrease infection rates after ureteroscopic stone treatment.

Antimicrobial Therapy in Preventing Wound Infection Following Appendicectomy in Uncomplicated Appendicitis: A Comparative Study Between Single Dose And Multiple Doses In Adults

Objectives: To find out the efficacy of single dose antibiotic vs multiple dosesin preventing wound infection following appendicectomy for uncomplicated appendicitis.&#x0D; Methods: A prospective comparative study was conducted in the Department of Surgery, Chittagong Medical college Hospital from January'2009 to June'2009. 100 patients with uncomplicated appendicitis who underwent appendicectomy during that period were included in this study. Among them 50 cases were included in study group ·(SG) who were given only single dose of combination drugs ( lnj. Cefuroxime + lnj. Metronidazole).ln rest of the 50 cases (CG), antibiotics were continued for 7 days postoperatively.&#x0D; Result: Maximum incidence of acute appendicitis was in the 2nd and 3rd decade of life with male preponderance .Rate of wound infection in the study group and control group was 4% and 2% respectively which was not statistically significant .The duration of antibiotic therapy had no significant effect on the length of hospital stay between the two groups ; 2.48 days vs 2.9 days [mean + s.d. 69.6 # 16.8 hours ] in the study and control group respectively, though treatment cost was higher in control group in comparison to the study group .&#x0D; Conclusion: Single dose of preoperative antibiotics is adequate for prevention of postoperative wound infection following appendicectomy for uncomplicated appendicitis.&#x0D; Journal of Surgical Sciences (2015) Vol. 19 (1) : 17-20