Efficacy of short term versus long term antibiotic therapy in preventing deep wound infections in elective orthopaedic surgeries

Authors

  • Saurabh Chandrakar Department of Orthopaedics, Pt. BD Sharma PGIMS, Rohtak, Haryana
  • Ankit Mittal Department of Sports Medicine, Pt. BD Sharma PGIMS, Rohtak, Haryana
  • Jalaz Jain Department of Orthopaedics, Satyawadi Raja Harishchandra Hospital, Narela, New Delhi
  • Himanshu Bansal Department of Orthopaedics, Pt. BD Sharma PGIMS, Rohtak, Haryana
  • Prateek Ahlawat Cygnus Multispeciality Hospital, Kurukshetra, Haryana
  • S. S. Sangwan Department of Orthopaedics, Pt. BD Sharma PGIMS, Rohtak, Haryana
  • Rakesh Sharma Department of Orthopaedics, Pt. BD Sharma PGIMS, Rohtak, Haryana
  • Hitanshi Arora Department of Obstetrics and Gynaecology, Pt. BD Sharma PGIMS, Rohtak, Haryana

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20204338

Keywords:

Surgical site infection, Antibiotic therapy, Wound infection, Orthopedic surgery

Abstract

Background: Comparison of the efficacy of short term (up to 48 hours) versus long term (five days) antibiotic therapy in preventing deep wound infections in elective orthopaedic surgeries.

Methods: Two hundred patients of all ages and both sexes were divided into two groups of 100 patients. One group received long term antibiotic treatment consisting of 2 days intra-venous cefoperazone sulbactam 1.5 gm twice daily and intra-venous amikacin 500 mg twice daily followed by 3 days of oral amoxicillin clavulunate 625 mg thrice daily. Other group received short term antibiotic of 2 days intra-venous cefoperazone sulbactam 1.5 gm twice daily and intra-venous amikacin 500 mg twice daily. Comparison of SSI was done with age, sex, BMI, pre-operative haemoglobin, TLC, duration of surgery in both the groups.

Results: In group I and group II respectively, average duration of surgery in procedures involving implants was 65.02±27.41 and 59.47±20.27 minutes and non implant related procedures was 53.66±23.97 and 53.74±22.40 minutes. Overall incidence of SSI in Group I and Group II was 14% and 10% respectively. Mean infection in the present study was 12%.

Conclusions: It was concluded that in clean orthopaedic elective surgeries short term antibiotics regimen is as effective as long term antibiotics regimen. Continuing antibiotics for more than two days is associated with drug related complications like allergic reactions and gastrointestinal upset, adverse interactions in other drugs, development of resistant organisms and it adds to overall cost of treatment.

Author Biographies

Saurabh Chandrakar, Department of Orthopaedics, Pt. BD Sharma PGIMS, Rohtak, Haryana

Senior Resident, Department of Orthopaedics, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India

Ankit Mittal, Department of Sports Medicine, Pt. BD Sharma PGIMS, Rohtak, Haryana

Senior Resident, Department of Sports Medicine, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India

Jalaz Jain, Department of Orthopaedics, Satyawadi Raja Harishchandra Hospital, Narela, New Delhi

Senior Resident,  Department Of Orthopaedics, Satyawadi Raja Harishchandra Hospital, Narela, New Delhi, India

Himanshu Bansal, Department of Orthopaedics, Pt. BD Sharma PGIMS, Rohtak, Haryana

Junior resident, Department of Orthopaedics, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India

Prateek Ahlawat, Cygnus Multispeciality Hospital, Kurukshetra, Haryana

Consultant, Cygnus Multispeciality Hospital, Kurukshetra, Haryana, India

S. S. Sangwan, Department of Orthopaedics, Pt. BD Sharma PGIMS, Rohtak, Haryana

Ex Senior Professor, Department of Orthopaedics, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India

Rakesh Sharma, Department of Orthopaedics, Pt. BD Sharma PGIMS, Rohtak, Haryana

Junior resident, Department of Orthopaedics, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India

Hitanshi Arora, Department of Obstetrics and Gynaecology, Pt. BD Sharma PGIMS, Rohtak, Haryana

Senior resident, Department of Obstetrics and Gyanecology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India

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Published

2020-10-22

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Original Research Articles