Prospective Randomized Study on the Effectiveness of Oral Antibiotic Prophylaxis in Preventing Surgical Site Infection in Elective Colorectal Surgery

Title: Prospective Randomized Study on the Effectiveness of Oral Antibiotic Prophylaxis in Preventing Surgical Site Infection in Elective Colorectal Surgery

Authors: Govindappa Saroja Murali*, Preetham Rai

DOI: http://dx.doi.org/10.18535/jmscr/v4i8.26

Abstract

References

Corresponding Author

Abstract

Background: Surgeries of the colon and rectum are categorized as clean-contaminated procedures. Increased incidence of surgical site infections associated with these procedures make antibiotic prophylaxis and bowel preparation an essential component in the preoperative preparation of the patients. While the role of intravenous antibiotics is well established, controversy still exists over the use of oral antibiotics for prophylaxis. This study was undertaken to evaluate the role of oral antibiotic prophylaxis in preventing/ reducing the incidence of wound infection following elective colorectal surgeries.

Methods: 82 patients who underwent elective surgeries on the colon/rectum over 32 months were included in the study. They were randomized into two groups – Group 1 (with oral prophylaxis) and Group 2 (without oral prophylaxis). Postoperatively intravenous antibiotics were given for 2 days following which no antibiotics were given. Wound was inspected for evidence of infection.

Results: Overall incisional SSI rate was 31%. Infection rate was higher in females (33.3%) than in males (30%). Patients with higher ASA grade had high infection rates (p<0.0001) (Grade I – 14.3%; Grade II – 26%; Grade III – 50%). Patients in age group > 60 yrs had increased infection rates (p<0.0001) (20 – 40 yrs – 14.3%; 40 – 60 yrs – 26.1%; > 60 yrs – 50%). 5 patients from Group 1(n=40) and 8 from Group 2 (n=42) developed incisional SSI without any statistically significant difference (p=0.514). One patient developed urinary tract infection.

Conclusion: This study did not find any significant role for oral antibiotics in decreasing the infection rates. Hence oral antibiotics need not be administered preoperatively for colorectal surgeries.

Keywords: Antibiotic prophylaxis, Surgical site infection, Colorectal surgery.

References

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