Mannasseril Antony Kunjamma1, Kala Bahuleyan Santha2, Fiji Raj3
BACKGROUND
Surgical
site infections are the most common nosocomial infections. Postoperative complications especially surgical site
infections can double the length of time a patient stays in hospital and increase the cost of healthcare. Antibiotic prophyla xis
before surgery has evolved over last twenty years and is definitely valuable to reduce postoperative wound infection. Obstetric
surgeries are considered as clean contaminated wounds where antibiotic prophylaxis has proven beneficial in preventing
postoperative complications, antibiotic resistance and economic burden. But in countries like India even a l arge group of
obstetricians are reluctant to follow it. Hence this study was conducted.
The aim of the study is to
study the effectiveness of single dose c efazolin prophylaxis in preventing postoperative
complications in patients undergoing elective c esarean compared to postoperative antibiotics.
MATERIALS AND METHODS
This was a prospective observational study conducted in the
Department of Obstetrics and Gynaecology , Medical College
Kottayam from January 2014 December 2014. After obtaining permission from the hospital ethical committee for research,
hundred patients undergoing elective cesarean in our hospital were selected for the study using strict inclusion and exclusio n
criteria of which fifty patients rece ived injection cefazolin 2g intravenously one hour before surgery. Remaining fifty patients
who were matched for age, parity and body mass index were given cefotaxime and metronidazole pre and postoperatively. All
these patients were followed up postoperat ively for complications, antibiotic change and duration of hospital stay. Statistical
analysis done using suitable software.
RESULTS
Complications were comparable in those receiving prophylactic
c efazolin and those receiving postoperative antibiotics. Bot h
groups required antibiotic change for complications. Patients requiring prolonged hospital stay was comparable in both the
groups S urgical site infections was the commonest cause of prolonged hospital stay.
CONCLUSION
Antibiotic prophylaxis with
cefazolin i s as effective as postoperative antibiotics in preventing post operative complications in a
major referral centre in India. Hence antibiotic prophylaxis should be preferred in uncomplicated surgeries as it reduces
patient ’s morbidity, antibiotic resistance and workload of hospital staff.
