Efficacy of prophylactic antibiotic usage to that of regular antibiotics usage in patients undergoing elective caesarean section

Abstract

Background: Surgical site infections better prevented by parenteral antibiotic in sufficient doses generally should be given before the operation which helps to achieve the therapeutic drug level both in the blood and related tissue during the operation. Ceftriaxone, when administered together as a prophylaxis can fulfil the above criteria of a good antibiotic. Aim: This study was planned to assess the efficacy of prophylactic antibiotic usage to that of regular antibiotics usage in patients undergoing elective surgeries. Material and methods: A comparative Prospective study was conducted in the Department of obstetrics and gynaecology, Narayan Medical College and Hospital, Sasaram, Bihar, India from July 2018 to December 2019. Total 200 Patients for elective LSCS and BMI < 30 were include in this study. Group A - patients received injection Ceftriaxone 1gm. intravenous stat at the time of induction of anesthesia. Group B - patients received intravenous ampicillin and metronidazole for 1 day followed by oral for next 5 days. Temperature monitoring, vital signs, abdominal, perineal examinations were performed daily till 5-7days. Results: Patients were randomly divided on alternate number basis, in 2 groups (Group A Ceftriaxone 1gm iv stat and Group B ampicillin and metronidazole for 5 days) each consisted of 100 patients. Mean age was 24.5±4.2 years in group A & 23.4±3.8 years in group B. BMI at the time of admission was 27.9±7.8 kg/m² & 28.8± 6.2 kg/m² in group A & B respectively. Mean duration of surgery was 45.8±6.8 min in group A & 46.1±5.4 in group B. Average blood loss was in groups A 645±70 & 670±75 in group B was comparable. Mean days of hospitalisation was 4.6±4.1 days & 5.4±3.1 days in group A & B respectively. History of previous laparotomy like LSCS, ectopic surgery, etc. was present in 42 & 36 patients from group A & B respectively. Fever was most common morbidity noted (Group A – 7& Group B -5) followed by urinary tract infection (Group A – 5 & Group B -7), wound infection, endometritis & early neonatal sepsis. Statistical difference between group A & B was non significant for all morbidities. Conclusion: We conclude that the single dose antibiotic prophylaxis is as effective as conventional multi dose antibiotic therapy.