The Efficacy of Short-Term vs. Long-Term Antibiotic Therapy in Preventing Deep Infection After Orthopedic Procedures (A Prospective Observational Study)

Khorrami, Mohsen; Tabatabaei, Saeid; Mirabbas, Ahmadarabi

doi:10.5812/jjm.3521

Cited by 4 publications

(7 citation statements)

References 15 publications

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“…In our results we used cefotaxime and similar done by Kulkarni et al in India particularly Ceftriaxone and Cefotaxime preferred [14] , Similar results were found in study done by Khorrami [12,[15][16] . Various guidelines also recommends cefazolin 1gm intravenous single dose or maximum of 3 doses 8 hourly for 24 hours postoperatively as preferred antimicrobial for surgical prophylaxis of clean orthopaedic surgical procedure with implant or clean contaminated surgical procedure.…”

Section: Discussionsupporting

confidence: 88%

A single antibiotic & early discharge in orthopaedic

Azeem¹,

Patil²

2019

Int. J. Orthop. Sci.

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Background: Prophylactic antimicrobials play an important role in the prevention of surgical site infections (SSI), which is one of the most preventable causes of postoperative complications. It is not clear whether the perioperative prophylaxis of a portion of anti-infective agents is sufficient to prevent wound contamination. The purpose of this test was to evaluate whether the fight against infection of a perioperative part was successful in counteracting. Methods: Participants were administered a single antibiotic of 1 g of cefotaxime intravenously 30 minutes before surgery followed by 12 hourly for 3 days. Patient were mobilised after 12 hours and discharged on 3 rd day. The incidence of postoperative complications such as wound infections, wound resuturing, etc. was monitored. Results:The study included 50 clean and closed orthopaedic operations out of which only one patient had superficial wound infection. The organisms isolated from wound infection were E. coli, Pseudomonas, which were sensitive to co-trimaxozole. The normal duration of the stay was only 3 days. Conclusions: A single antibiotic of cefotaxime is equally effective, early mobilization and early discharge is useful and safe for orthopaedic surgery.

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Section: Discussionsupporting

confidence: 88%

A single antibiotic & early discharge in orthopaedic

Azeem¹,

Patil²

2019

Int. J. Orthop. Sci.

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“…So our results are similar to study done by Kulkarni et al in India in which more than 80% of the surgeons preferred single drug as third generation cephalosporins, particularly Ceftriaxone and Cefotaxime and preferred combination of cephalosporin with aminoglycoside for all types of surgeries. [14] Similar results were found in study done by Khorrami [12,[15][16][17][18][19] A study by Patzakis reported that the combination therapy (cephalosporin + aminoglycoside) was associated with a 4.6% infection rate, whereas administration of only cephalosporin was associated with a 13% infection rate. So use of Cephalosporin with aminoglycoside in our study was justified.…”

Section: Discussionsupporting

confidence: 78%

“…Our result is nearly similar to study done by Kulkarni days) in Egypt. [9,[14][15][16]26] Though in our study prolonged prophylaxis was given, but it is not recommended. Current US guidelines recommend administration of antimicrobial prophylaxis within 120 min or 60 min of incision.…”

Section: Discussionmentioning

confidence: 97%

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Use of antimicrobial prophylaxis in clean elective orthopedic surgical procedures and identifying common infective organisms

Mistry¹,

Pandya²,

Chaudhari³

et al. 2013

Int J Med Sci Public Health

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Background: Prophylactic antimicrobials have an important adjuvant role in the prevention of Surgical Site Infection (SSI), which is one of the most preventable causes of post-operative complication. In India, due to lack of adequate information and guidelines for antimicrobial prophylaxis in surgery there is a need to generate baseline data on the pattern of use of prophylactic antimicrobials. Aims & Objective: This study is aimed to analyze the pattern of surgical chemoprophylaxis and surgical site infection (SSI) rate in patients who underwent elective orthopedic surgical procedure. Material and Methods: A prospective, observational study was performed on patients undergoing surgery, in a tertiary care teaching hospital. Data were collected in a pro-forma which included the patients' details, prescriptions from date of admission to discharge or any other outcome and operative notes. Surgical site infection as defined by Centre for Disease Control criteria was recorded. Results: Total 305 patients were enrolled over a period of one year. In 237 (77.70%) patients antimicrobials prescribed by generic name. In preoperatively and intraoperatively, all the patients received parenteral antimicrobial. Postoperatively, 294 (96.40%) patients received only parenteral antimicrobials while in 11 (3.60%) patients received parenteral antimicrobials followed by oral antimicrobials. Preoperatively antimicrobials started 12 hours prior to surgery. Average duration of antimicrobials given postoperatively was 5.05 ± 1.14 days. Third generation Cephalosporins and Aminoglycosides were prescribed most frequently. Average number of antimicrobials used per patient was 4.40 ± 1.05. In follow up 37 (13.03%) patients developed SSI and most common isolated organism was Staphylococcus aureus. Conclusion: Surgical chemoprophylaxis was inappropriate in terms of choice of antimicrobial agent, timing of administration as well as the total duration of prescription, in majority of the cases, leading to higher SSI. Interventions are warranted to promote the development, dissemination and adoption of evidence based guidelines for antimicrobial prophylaxis.

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“…Patient risk factors thought to increase the chance of SSI include advanced age, poor nutritional status, obesity, smoking, diabetes, altered immune response, length of preoperative stay, colonization with micro-organisms, coexisting infections remote from operative site, setting of the procedure (elective or emergent, clean or contaminated, and others). 13 Certain procedures are associated with low risk for a SSI, and the risks of antimicrobial prophylaxis may outweigh the benefits. Risks include allergic reactions, toxic side effects of antimicrobials, adverse interactions with other drugs, and development of resistant organisms.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of short term versus long term antibiotic therapy in preventing deep wound infections in elective orthopaedic surgeries

Chandrakar

Mittal

Jain³

et al. 2020

Int J Res Orthop

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Background: Comparison of the efficacy of short term (up to 48 hours) versus long term (five days) antibiotic therapy in preventing deep wound infections in elective orthopaedic surgeries.Methods: Two hundred patients of all ages and both sexes were divided into two groups of 100 patients. One group received long term antibiotic treatment consisting of 2 days intra-venous cefoperazone sulbactam 1.5 gm twice daily and intra-venous amikacin 500 mg twice daily followed by 3 days of oral amoxicillin clavulunate 625 mg thrice daily. Other group received short term antibiotic of 2 days intra-venous cefoperazone sulbactam 1.5 gm twice daily and intra-venous amikacin 500 mg twice daily. Comparison of SSI was done with age, sex, BMI, pre-operative haemoglobin, TLC, duration of surgery in both the groups.Results: In group I and group II respectively, average duration of surgery in procedures involving implants was 65.02±27.41 and 59.47±20.27 minutes and non implant related procedures was 53.66±23.97 and 53.74±22.40 minutes. Overall incidence of SSI in Group I and Group II was 14% and 10% respectively. Mean infection in the present study was 12%.Conclusions: It was concluded that in clean orthopaedic elective surgeries short term antibiotics regimen is as effective as long term antibiotics regimen. Continuing antibiotics for more than two days is associated with drug related complications like allergic reactions and gastrointestinal upset, adverse interactions in other drugs, development of resistant organisms and it adds to overall cost of treatment.

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The Efficacy of Short-Term vs. Long-Term Antibiotic Therapy in Preventing Deep Infection After Orthopedic Procedures (A Prospective Observational Study)

Cited by 4 publications

References 15 publications

A single antibiotic & early discharge in orthopaedic

A single antibiotic & early discharge in orthopaedic

Use of antimicrobial prophylaxis in clean elective orthopedic surgical procedures and identifying common infective organisms

Efficacy of short term versus long term antibiotic therapy in preventing deep wound infections in elective orthopaedic surgeries

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