Single shot versus multiple shot antibiotic therapy in patients undergoing laparoscopic surgery: our experience

Abstract

The aim of our study was to see the effect of single dose regime versus multi dose regime of antibiotic in laparoscopic surgery; in terms of type of laparoscopic surgery done, type and dose of intravenous antibiotic given and the occurrence of post operative complications like wound gape, stitch abscess, local pain and discharge from the wound in both the groups. The present study was prospective, observational and longitudinal. Protocol of the procedure was formed along with Performa, Patient Information Sheet and Informed Consent Form. The present study was carried out in surgery department of C.U Shah medical college, Surendranagar; Gujarat state. The study was carried out from 1st October 2010 till 31st August 2012. A total of one hundred and twenty patients undergoing emergency and elective laparoscopic surgery were included in our study. Case records of patients was recorded in the Performa containing demographic details, chief complaints, provisional diagnosis, details of operative procedures and drug details during the hospital stay. Follow up of the patients was done after one and three weeks and any change of regime of antibiotics was noted in respect to the symptoms or clinical findings like pain, fever, discharge, stitch abscess, wound gape. Out of 120 patients enrolled mean age was 38.88±14.19. Out of 120 patients in the study; 63 (52.5%) were Male and 57 (47.5%) were Female. Intravenous antibiotics were used in single dose or multiple dose in the patients undergoing laparoscopic procedures. Single dose of antibiotic was given to 65 patients and multiple dosage of antibiotics was given to 48 patients while 7 patients were converted from single to multiple dosage regime of antibiotics. Choice of a dosage of an appropriate antibiotic is of utmost importance in the treatment of the patients and the post operative outcomes. The adverse effects of the used antibiotics must also be kept into consideration while choosing the antibiotics and its dosage. Thus based on our study we conclude that single and multiple dosages of antibiotic regimes can be used for laparoscopic surgeries. However, single dose of antibiotics are more patient compliant, cost effective, less adverse effects and prevents emergence of antibiotic resistance. [Int J Res Med Sci 2013; 1(3.000): 252-256

Comparison Between Single Dose Versus Multiple Doses Antibiotics in Laparoscopic Cholecystectomy

“…The use of antibiotics in laparoscopic cholecystectomy is still arguable as some study still suggest that multiple doses of antibiotics have better outcome postoperatively. 15 In our study, the mean age of the patients was 37.37±14.3 years where 79(32%) were in the age group of 21 -30 years which was similar to the observation made by Shah YD et al 14 20 which concluded that there was no significant difference in outcome with SD or MD antibiotics use. Surgical site infection may occur even in clean surgery as numerous microbial factors play role in that.…”

Post-Operative Infection Rate Between Single Dose Versus Multiple Dose Antibiotic Therapyin Patients Undergoing Laparoscopic Cholecystectomy

“…17 Single dose of antibiotics emerged as equally effective, more cost-friendly, well tolerated and a preferred option as compared to multiple dose antibiotics in minimally invasive surgeries like laparoscopic cholesystecotmy. 18 Meijer et al 19 conducted a randomized, controlled, double-blind, multicenter trial, and they did not find any significant difference between the one-dose and multiple dose regimens in preventing post-operative wound infection. However, Waldvogel et al 20 have suggested that SSI may be found even in clean surgery as numerous microbial factors play a role, and antibiotic prophylaxis for not more than 24 hours is sufficient to prevent it as the critical period for the development of infection is short.…”