Publication:

Antibiotic prophylaxis versus empirical therapy in routine abdominal hysterectomy in tertiary care hospital

Background Surgical site infection remains an important cause of postoperative morbidity after abdominal hysterectomy. Although antibiotic prophylaxis is widely recommended, empirical postoperative antibiotic therapy is still commonly practiced in many tertiary care settings. This study aimed to compare the clinical outcomes of antibiotic prophylaxis and empirical therapy in routine abdominal hysterectomy.

Methods This comparative study included 88 women undergoing routine abdominal hysterectomy in the Department of Obstetrics and Gynaecology, Chittagong Medical College Hospital. Participants were divided into two groups of 44 patients each. Group-A received antibiotic prophylaxis with intravenous ceftriaxone 1 g, administered 30 minutes before surgery. Group-B received the same preoperative dose followed by intravenous ceftriaxone 1 g 12-hourly for 72 hours and oral cefixime 400 mg twice daily for 7 days. Patients were followed for 30 days. Outcomes included superficial surgical site infection, postoperative complications, further antibiotic requirement, wound condition and duration of hospital stay.

Results Superficial surgical site infection occurred in 5 patients (11.4%) in Group-A and 7 patients (15.9%) in Group-B, with no statistically significant difference (p=0.534). Postoperative complications were observed in 43.2% of Group-A and 36.4% of Group-B patients (p=0.513). Further antibiotic use was required equally in both groups, 8 patients (18.2%) each (p=1.000). Healthy wound condition during follow-up was observed in 88.6% and 86.4% of patients, respectively (p=0.747). Mean hospital stay was 6.75±4.27 days in Group-A and 8.18±6.42 days in Group-B (p=0.221).

Conclusions Single-dose antibiotic prophylaxis showed comparable clinical outcomes to empirical postoperative therapy in routine abdominal hysterectomy and may support rational antibiotic use.