Role of single dose antibiotic prophylaxis in clean orthopedic surgery

Abstract

Objective: To compare the proportion of early postoperative infection in clean orthopedic surgery after single dose of prophylactic antibiotic and multiple doses of prophylactic antibiotic.

Design: Interventional quasi-experimental study.

Place and duration of study: Department of Orthopedics, Abbasi Shaheed Hospital, Karachi from April 2004 to March 2005.

Material and methods: Two hundred patients of either age and gender, undergoing clean orthopedic surgery were equally divided into two groups A and B. Group A was given single dose of prophylactic antibiotic, while group B was given multiple doses of prophylactic antibiotic. Follow-up period was 28 days. All cases were evaluated for postoperative wound infection. Sampling technique was non-probability convenience.

Results: Mean age was 35.51+/-20.79 years in group A and 26.17+/-19.79 years in group B. However, there was a significantly higher proportion of male patients in group B than in group A (p=0.006). Statistical analysis showed no significant difference in the proportion of early postoperative infection cases between the two groups(p=0.270). Staphylococcus aureus was the commonest organism cultured from the wound discharge in our study followed by E. coli. Eight of our cases having postoperative wound infection showed no growth, out of which 7 were superficial and 1 was deep. There was no significant difference between the two groups regarding mean operating time and duration of stay in hospital.

Conclusion: There was no statistically significant difference in the proportion of early postoperative infection cases between the two groups.