A study on antibiotic single dose efficacy and its prophylaxis in inguinal hernioplasty

Author : G V Ramana, B Visweswara Rao

Surgical site infection (SSI) is the most frequent complication in inguinal hernioplasty. SSI is related with an increase in length of stay and costs and a decrease in quality of life. Use of antibiotics in Lichtensteinís hernia repair is still debatable in a rural set up. Another subject in rural setup that must be addressed in antibiotic prophylaxis is cost-effectiveness. In these cases, the costs of antibiotic administration must be carefully evaluated against the potentials benefits. The study was conducted out between December 2014 to October 2015 on 60 patients .The patients were assigned alternately into 2 groups .Cases in Group A received single dose of pre-operative antibiotic 30 minutes before surgery and cases in group B received multiple doses perioperatively. The patients were then monitored post operatively from the second day onwards for SSI. The data was collected and statistics done using the Chi square/Fischer exact test to look for significant difference in the rate off SSIs in both the groups and also to find out if it was cost effective. Incidence of SSI in group A was 3,33%( 1 in 30)Incidence of SSI in group B was 6.6%( 2 in 30).Incidence of SSI though higher in group B than group A was not statistically significant when Fischer exact test was applied. The cost of antibiotic per patient in group A was Rs.32 while that in group B was between a minimum of Rs.152 in patients without SSI to a maximum of Rs.240 with SSI. The difference in cost of antibiotic in both groups was statistically significant. Single dose antibiotic prophylaxis was therapeutically efficient as well as cost effective in comparison with multiple doses of perioperative antibiotics usage for the prevention of surgical site infection in uncomplicated elective cases of Lichtensteinís hernioplasty

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