ANTIBIOTIC SUSCEPTIBILITY PATTERNS IN POST-OPERATIVE INFECTIONS IN ORAL CANCER PATIENTS IN A TERTIARY CARE CENTRE IN SOUTH INDIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 42
Abstract
BACKGROUND The use of antibiotic prophylaxis in head and neck oncologic surgery has greatly reduced the risk of post-operative wound infection and the corresponding increase in morbidity and health care costs. Aim: To study the culture sensitivity pattern in patients with infections following surgical resection for oral squamous cell carcinoma and the post-operative antibiotic use in a surgical unit at a tertiary centre in South India. MATERIALS AND METHODS Retrospective review of case records of all patients who underwent surgical excision for oral squamous cell carcinoma under the Department of General Surgery Unit I, Christian Medical College, Vellore from January 1, 2013 to December 31, 2013. Statistical Analysis-Epidata® was used for data entry and SPSS 20® was used for data analysis. RESULTS A total of 86 patients underwent surgical excision of oral squamous cell carcinoma in 2013, which included 57 males and 29 females. Majority of these patients were within 41 years to 60 years of age (Range: 25 - 82 years). Thirty-five patients had carcinoma of the tongue followed by 29 with carcinoma of buccal mucosa, 17 patients with carcinoma of alveolus, 2 patients with carcinoma of lower lip, 2 patients with carcinoma of retromolar trigone and one patient with carcinoma of the floor of mouth. Thirty-three of these underwent primary closure following resection, 28 of them needed a regional flap, 14 of them underwent microvascular free-flap reconstruction and 11 needed local flaps for closure of the defect. Pseudomonas aeruginosa was the most common organism found in surgical site infections in these patients at our centre followed by other non-fermenting gram-negative bacteria and Staphylococcus aureus. Most pus cultures were polymicrobial. Pseudomonas aeruginosa was also the most common organism causing urinary tract infections in post-operative patients followed by Enterococcus and Klebsiella. CONCLUSION There was no statistical association between the infection rate and the site of operation or the type of operation. The surgical site infection rate was 12.8% with Cefoperazone-Sulbactam and Metronidazole antibiotic prophylaxis. The infection rate was higher when regional and microvascular free flaps were used for reconstruction of the primary defect. Since the cultures are polymicrobial with predominant gram-negative organisms, Cefoperazone-Sulbactam is a better antibiotic cover than Cefazolin.
Authors and Affiliations
Rajeevan Philip Sridhar, Vasanth Mark Samuel, Pranay Gaikwad
Keywords
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- EP ID EP548491
- DOI 10.14260/jemds/2018/1006
- Views 71
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