Role of Prophylactic Antibiotics in Open Inguinal Hernia Repair: A Randomised Study

Abstract

To study the role of prophylactic antibiotics in open inguinal hernia repair. A total of 200 patients were included, they were randomised in two groups. Group 1 was given prophylactic dose of inj amoxy-clav while group 2 was given placebo only. Results were compared and Data analysed using the Chi-square test. Complications in both the groups were compared. Rate of serous discharge and seroma formation was 1% and 22% respectively in group 1 while 2% and 26% in group 2 also the rate of erythema and stitch abscess were 1% and none in group 1 and 2% and 1% in group 2 respectively. On statistical analysis these differences were not significant. Addition of prophylactic antibiotics in elective open inguinal hernia repair has no significant benefit over placebo although larger studies are required to prepare some uniform guidelines.

Network meta-analysis of antibiotic prophylaxis for prevention of surgical-site infection after groin hernia surgery

“…). Of 1683 original studies, 17 RCTs met the inclusion criteria, of which 13 had already been identified and included in previous meta‐analyses; four additional studies were identified, giving a total of 18 eligible RCTs.…”

“…Characteristics of the 18 RCTs are described in Tables and . Three and 15 trials respectively included herniorrhaphy and hernioplasty (prosthetic mesh). Four antibiotic classes were used in these studies: first‐generation cephalosporins, second‐generation cephalosporins, β‐lactam/β‐lactamase inhibitors and fluoroquinolones.…”

“…For the first‐ and second‐generation cephalosporin trials, intravenous cefazolin 1 g and cefuroxime in a 1·5‐g single dose were used respectively. For the two studies that examined fluoroquinolones, one RCT compared a single dose of intravenous levofloxacin 200 g with first‐generation cephalosporin and placebo (3‐arm study), and another compared oral ciprofloxacin 500 mg versus intravenous cefazolin 1 g. For the trials that examined β‐lactam/β‐lactamase inhibitors, two used a single combination dose of ampicillin and β‐lactamase inhibitor (ampicillin–sulbactam 1·5 g and ampicillin–clavulanate 1·2 g), whereas four RCTs used a single dose of amoxicillin–clavulanate in a dose ranging from 1 to 1·2 g.…”

“…Most RCTs included mainly patients with an ASA fitness grade of I or II. The majority used CDC criteria for diagnosis of SSI; four studies used clinical signs and symptoms for diagnosis, including wound erythema, purulent drainage, opened wound, requirement for antibiotics, stitch abscess and wound breakdown/dehiscence.…”

The Role of Single Dose Antibiotic Prophylaxis in Open Mesh Repair of Inguinal Hernia : A Prospective, Double Blind Randomized Trial

“…[8], [19], [20] Recent studies in Indian setting have consistently showed similar incidences of infection in the antibiotics prophylaxis group and control group. [21], [22], [23] However, in one of the studies the incidence of infection in the control group was quiet high.(10.5%). [21] In the recent Cochrane review, which evaluated patients of hernioplasty subgroup, showed that the antibiotic prophylaxis show a significant reduction of wound infection rates.…”