Single dose antibiotic prophylaxis in elective obstetric and gynaecological surgeries-a descriptive study

Abstract

Background: Wound infection is a common complication of obstetric and gynaecological surgeries. It is not clear whether single dose perioperative prophylaxis with antibiotics is sufficient to prevent wound infections. This study was conducted to assess whether perioperative single dose antibiotic is effective in preventing post-operative infections in women undergoing elective obstetric and gynaecological surgeries.Methods: Participants were administered a single dose of 1gm Cefotaxime intravenously before obstetric and gynecological surgery and followed up for the incidence of post-operative complications such as wound infections, wound resuturing etc.Results: Study included 154 electives obstetric and gynecologic cases. 86 were obstetric cases and 68 were gynecologic surgeries. For gynecologic surgeries Cefotaxime injection 1g IV was given 30 minutes before surgery and for obstetric surgeries the same was given after cord clamping. Incidence of febrile morbidity was 5.8% in obstetric cases and 10.3% in gynecologic cases. Incidence of wound infection was 2.32% in obstetric cases and 1.47% in gynecologic cases. Three cases had wound infection, the organisms isolated in wound infection were E. coli, Pseudomonas, Methicillin resistant staphylococcus which were sensitive to cefoperazone-sulbactum and linezolid. The mean duration of hospital stay was 8.2 days in obstetric and 8.03 days for gynecologic patients.Conclusions: Single dose Cefotaxime prophylaxis is equally effective compared to conventional multi-dose antibiotic therapy. It is cost effective and safe for both obstetric and gynecological surgeries.

Compliance with antibiotic prophylaxis guidelines in caesarean delivery: a retrospective, drug utilization study (indication-prescription type) at an Ecuadorian hospital.

“…The incidence of SSI in this study (1.35%) is lower than in other similar studies, where it reaches up to 40% [29][30][31][32][33]. In patients who were not given PAP, the incidence of SSIs was higher than in those who received pre-surgical antibiotics (1.63% vs 1.23%).…”

Effectiveness of oral versus parenteral antibiotics in cesarean section: an observational study

“…4 Implementation of proper aseptic and surgical techniques and use of antibiotics as prophylaxis will result in reduction of postoperative wound infections. 5 Purpose of prophylactic antibiotics is to reduce the bacterial load to a minimum level, so that it enables the patient's immunological defences to function adequately. 5,6 For antibiotics to be effective the levels should be adequate in tissue at the time of incision.…”

“…5 Purpose of prophylactic antibiotics is to reduce the bacterial load to a minimum level, so that it enables the patient's immunological defences to function adequately. 5,6 For antibiotics to be effective the levels should be adequate in tissue at the time of incision. Administration of antibiotics before skin incision may reduce the risk of postoperative infection.…”

“…Recent guidelines and publications suggest that single dose antibiotic prophylaxis is equally effective in clean contaminated surgical procedures. 3,5,8 There are strong recommendations by WHO guideline panel (2015) regarding the administration of prophylactic antibiotics before skin incision. 7,8 The GDG also favoured the use of single-dose antibiotic regimens given prior to or during caesarean section, in comparison to multiple-dose regimens which usually extend to the postoperative period.…”

“…10 Rational use of prophylactic antibiotics and ceasing unnecessary use of postoperative antimicrobial prophylaxis, will help in prevention of post-operative infections, reducing the costs, shorten the duration of hospital stay, bed occupancy and development of antibiotic drug resistance. 3,5,6 Recently, there is desperate increase in demand of hospital beds and increasing cost of medical care have given added incentive to implement effective methods to decrease the post-operative morbidity.…”