“Outcome of Prophylactic Antibiotic Therapy: A comparisonbetween Short Prophylactic Antibiotic Therapy (SPAT) and Prolonged Antibiotic Therapy (PAT)”
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 1
Abstract
Surgical Site Infection (SSI) is the most common postoperative complication causing increased morbidity, mortality, hospital stay and high cost of treatment. Many aseptic precautions are applied to prevent SSI. Use of prophylactic antibiotic is a recognized and worldwide acceptable means to prevent SSI in clean contaminated surgery. But antibiotic regimen is still controversial in place to place and hospital to hospital. Somewhere single dose is used but somewhere 3 doses (Short Prophylactic Antibiotic Therapy- SPAT) and 7 days conventional (Prolonged Antibiotic Therapy- PAT) dose is used. But which regimen is more acceptable is a matter of study. This interventional type of experimental study was carried out on 300 consecutive and purposive cases upon which clean contaminated surgery performed in Rajshahi medical college hospital from July 2010 to June 2012 for the period of 2 years. According to selection criteria, 300 patients of different diseases including chronic calculus cholecystitis, Recurrent Appendicitis, Benign prostatic hyperplasia (BPH), Ureteric calculus and GOO (Pyloric stenosis) are included and underwent surgery. Total cases were divided into two equal groups (n=150). One group received 3 doses of prophylactic antibiotic (SPAT) and the other group received 7 days conventional antibiotic therapy (PAT). Postoperatively all the cases were followed up for 1 month to detect the presence of surgical site infection (SSI). Total 7% (21) cases of SSI were found in 300 cases. Among 150 cases of SPAT group had SSI rate 7.3% and on the other hand 150 cases of PAT Group had SSI rate 6.66% which indicate a concept of almost equal efficacy of both two regimen of antibiotic therapy. Even in case of same operation (e.g. Open Cholecystectomy), SSI rate comparison between two groups of patients was also very similar. E.g. after open cholecystectomy (n=100), SPAT group (n=50) had SSI rate 4% and PAT group (n=50) had 6%. It was also observed that after elective appendicectomy, former group had SSI rate 7.27% and that in the latter group was 7.27%. Similarly comparative analysis was done regarding hospital stay and average cost of antibiotic. In this study it was found that average hospital stay of SPAT group was 4.42 days whereas that of PAT group was 6.15 days. Regarding the cost of antibiotic therapy SPAT group had to bear significantly less cost. Average cost of antibiotic of former group was 498.13 Tk. whereas that of later group was 1671.66 Tk. It is the practical picture of Rajshahi medical college hospital. ln many surgical units long term (7-10 days) antibiotic therapy is being used after clean and clean-contaminated surgeries without thinking its necessity, cost and hospital stay. This study may be evidence that only short prophylactic antibiotic of 3 doses (SPAT) probably can serve all the purposes of prolonged unnecessary costly regimen of antibiotic therapy.
Authors and Affiliations
Dr. Md. Mohibul Hassan, Dr. Subal Chandra Paul, Dr. Asim Sarkar, Dr. Sanchita Sarker
Keywords
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- EP ID EP444200
- DOI 10.9790/0853-1801137579.
- Views 61
- Downloads 0
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