The Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection


BSTRACT: BACKGROUND: Surgical site infection is one of the commonest complications after surgical operations and the useof antibiotics in preventing or reducing infection is associated with many problems.OBJECTIVE:To evaluate the use of peri- operative prophylactic antibiotics in preventing or reducing surgicalsite infection in different types of operations PATIENTS AND METHODS:This prospective study was conducted on(560) patients from June 2002 to January 2007 in generalsurgical department in Baghdad teaching hospital.The patients were divided into( 3) groups according to the type of operation; clean operationswhich included 200 patients, clean-contaminated operations which included 160 patients andcontaminated operations which included 200 patients) and they were further subdivided into 2groups, group A of patients were treated with peri operative prophylactic Cefotaxime antibioticwhile the group B patients were treated with therapeutic dose of the same antibiotic for prolongedduration (5 days).Those patients were followed up for 4 weeks after operation and when signs of wound infectionappeared, swab for culture and sensitivity was taken to determine the type of bacteria, and effectiveantibiotics against them.RESULT:Result showed that (3) patients (3%) in clean surgery developed wound infection when usingperioperative regimen as compared to( 2) patients (2%) when using therapeutic regimen. In cleancontaminated wounds infection appeared in (5) patients (5%) in patients using prophylactic orpostoperative regimen while in contaminated wounds, (11) patients (11%) developed woundinfection when using perioperative regimen as compared to( 6) patients (6%) who developedwound infection in patients using postoperative antibiotics.Statistically, there is little difference in effectiveness of the two regimens (A and B) in both group(1) and( 2) operations but in the group( 3) operations, although prophylactic antibiotic regimenreduced the infection rate to 11% but it was not as effective as the therapeutic regimen in reducingwound infection (6%) .CONCLUSION: Postoperative antibiotics should be resisted in clean and clean contaminated operations insteadperioperative antibiotics can be used, and prolonged postoperative antibiotics should be usedonly in contaminated operations