Publication:

Incidence of surgical site infection in patients undergoing clean, clean contaminated cases with respect to antibiotic prophylaxis: a prospective observational study

Background Surgical site infection (SSI) is the most surveyed and frequent type of healthcare associated infection in low-middle income countries. With the advent of antibiotics its incidence has been decreased but prolonged use of prophylactic antibiotics in clean and clean contaminated surgeries has increased substantial burden on healthcare system.

Methods This is a single centric, prospective, observational study. In the period over 12 months, patients which were admitted for elective clean, clean contaminated surgeries were assessed preoperatively, intraoperatively and postoperatively. The patients in the study group received 1 dose of prophylactic antibiotic in clean cases and 3 doses in clean-contaminated cases according to the protocol and control group patients didn’t follow this criterion.

Results Incidence of SSI is 2.26% in study group, which was not significantly high compared to control group which was 1.97. Incidence of superficial SSI is higher in both study and control group as compared to deep SSI. The most common isolate from wound culture was Staphylococcus aureus. Also strain of E. coli, sensitive strain of Pseudomonas and resistant strain of Klebsiella pneumonia were isolated.

Conclusions Irrational use of prophylactic antibiotics in clean and clean contaminated cases is not beneficial and just adding the cost and increasing the chances of development of antibiotic resistant strains.