Koppolu Shanmukha, Suresh Lathika, Munusamy Rakshana, Prashanth A, Pascal Shoraf, Emandi Alekhya, Thangaraj Shri Mirunalini, Deshmukh Gaurav Vijayrao
Department of Trauma and Orthopedics, Whipps Cross University Hospital, Leytonstone, London, England, UK.
Department of Microbiology, Somervell Memorial C.S.I. Medical College and Hospital, Karakonam, P.O. Thiruvananthapuram, Kerala, India.
J Pharm Bioallied Sci. 2025 Jun;17(Suppl 2):S1188-S1190. doi: 10.4103/jpbs.jpbs_1573_24. Epub 2025 Jun 18.
Surgical site infections (SSIs) represent a significant challenge following general surgical procedures, affecting approximately 1 in 24 patients undergoing inpatient surgery in the United States. Despite advances in antibiotic therapies and antiseptic techniques, SSIs continue to impact surgical outcomes. Effective prophylactic antibiotic administration is critical for reducing SSI rates. This study aims to evaluate the effectiveness of single versus multiple-dose antibiotic prophylaxis in preventing SSIs in clean and clean-contaminated surgical procedures.
This prospective, comparative study was conducted at the Department of General Surgery, Madha Medical College and Research Institute. A total of 80 individuals receiving general surgical interventions with either sterile or slightly contaminated wounds were included. The sample size was calculated to achieve 95% confidence and 80% power. Patients were randomly assigned to receive either a single dose of antibiotic prophylaxis within 4 hours before surgery (Group A) or multiple doses (one the day before the operation and another 4 hours before the operation) (Group B). Postoperative monitoring was performed from days 3 to 8, with wound swab cultures taken for cases exhibiting signs of infection. Statistical analysis was performed using SPSS, with significance set at < 0.05.
The study found no significant difference in SSI rates between the single-dose and multiple-dose prophylaxis groups. Both groups showed comparable outcomes regarding wound infections and clinical parameters such as patient temperature and wound discharge. The Chi-square test and independent sample -test revealed no statistically significant differences in infection rates between the two prophylaxis regimens.
The findings suggest that a single dose of antibiotic prophylaxis is as effective as multiple doses in preventing SSIs in clean and clean-contaminated surgical procedures. The lack of significant difference in infection rates indicates that single-dose prophylaxis may be a viable alternative to multiple doses, potentially simplifying the prophylaxis protocol and reducing the risk of antibiotic resistance.
手术部位感染（SSIs）是普通外科手术后的一项重大挑战，在美国，每24例接受住院手术的患者中约有1例受其影响。尽管抗生素治疗和防腐技术取得了进展，但手术部位感染仍会影响手术结果。有效的预防性抗生素给药对于降低手术部位感染率至关重要。本研究旨在评估单剂量与多剂量抗生素预防在清洁和清洁-污染手术中预防手术部位感染的有效性。
这项前瞻性比较研究在马德哈医学院和研究所普通外科进行。共有80例接受无菌或轻度污染伤口的普通外科手术干预的患者纳入研究。计算样本量以达到95%的置信度和80%的检验效能。患者被随机分配在手术前4小时内接受单剂量抗生素预防（A组）或多剂量预防（手术前一天一剂，手术前4小时再一剂）（B组）。术后第3天至第8天进行监测，对出现感染迹象的病例进行伤口拭子培养。使用SPSS进行统计分析，显著性设定为<0.05。
研究发现单剂量和多剂量预防组之间的手术部位感染率无显著差异。两组在伤口感染以及患者体温和伤口引流等临床参数方面显示出相似的结果。卡方检验和独立样本检验显示，两种预防方案之间的感染率无统计学显著差异。
研究结果表明，在清洁和清洁-污染手术中预防手术部位感染时，单剂量抗生素预防与多剂量预防同样有效。感染率缺乏显著差异表明，单剂量预防可能是多剂量预防的可行替代方案，有可能简化预防方案并降低抗生素耐药性风险。
