The Use of Prophylactic Antibiotics in Day Case Herniotomy at Abia State University Teaching Hospital, Aba, Nigeria
Advances in Surgical Sciences
Volume 6, Issue 1, June 2018, Pages: 36-40
Received: Jul. 23, 2018;
Accepted: Aug. 17, 2018;
Published: Sep. 10, 2018
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Samuel Chidi Ekpemo, Department of Surgery, Abia State University, Aba, Nigeria
Sebastain Okwuchukwu Ekenze, Department of Surgery, University of Nigeria, Enugu, Nigeria
Uchechukwu Obiora Ezomike, Department of Surgery, University of Nigeria, Enugu, Nigeria
Background: There has been tremendous improvement in the knowledge of prophylactic antibiotics use in surgery. There are controversies on the use of prophylactic antibiotics clean surgical cases. This study aims to determine if there is need to use prophylactic cefuroxime in day case herniotomy at the Abia State University Teaching Hospital Aba. Objective: To determine if there is need for prophylactic antibiotics in paediatric day case herniotomy and to compare the rate of surgical site infection in patients that receive preoperative cefuroxime to patients that did not receive it. Method: This was a hospital based prospective study carried out between April 2017 and April 2018 during which 126 herniotomy were performed as day cases at the Abia State University Teaching Hospital Aba. The patients were randomly placed into two groups: 63 patients in group A that received prophylactic cefuroxime at induction of anaesthesia and 63 patients in group B that did not receive cefuroxime. The two groups were compared to determine the factors that influenced development of surgical site infection. Results: There were 115(91.3%) males and 11(9.7%} females. Their ages ranged from 1-14 years with a median of 2 years. The average duration of the operative procedure was 34.8 minutes (34.3 minutes in group A and 35.4 minutes in group B). After a follow up of 3 weeks, a total of 8 patients developed surgical site infection (3 patients in group A; 5 patients in group B) (p=0.358). The duration of operation (p= 0.549) and mode of transport (p=0.605) did not affect rate of surgical site infection. Conclusion: Development of surgical site infection after day case herniotomy in our hospital is not affected by the use of prophylactic antibiotics and duration of operation. The study confirms that day case herniotomy can be undertaken without prophylactic antibiotics.
Samuel Chidi Ekpemo,
Sebastain Okwuchukwu Ekenze,
Uchechukwu Obiora Ezomike,
The Use of Prophylactic Antibiotics in Day Case Herniotomy at Abia State University Teaching Hospital, Aba, Nigeria, Advances in Surgical Sciences.
Vol. 6, No. 1,
2018, pp. 36-40.
Kaiser BA, Herrington JR, Jacob LM, Albert CR, John LS. Antmicrobial prophylaxis in surgery. N Engl J Med 1986; 315:1129-38.
Bratzler WD, Houck PM. Antimicrobial prophylaxis in surgery. Clin Infect Dis 2004; 38:1706-15.
Lim VKE, Cheong YM, Suleiman AP. Pattern of antibiotic usage in Malaysia. Singapore Med J 1993; 34: 525-8.
Classen CD, Evans RS, Pestonik SL, Horn SD, Menlove RL, Buckee JP. The timing of prophylactic administration of antibiotics and risk of wound infection. N Engl J Med 1992; 326: 281-6.
Ansari SA, Saddique M, Azim W. Antibiotic prophylaxis in clean surgery. Biomedica 2005; 21:122-4.
Barone AJ, Hermes-Desantis ER. Adverse drug reactions and drug induced diseases. In: Herfinal TE, Gourley R. D (Editors). Textbook of Therapeutics: Drugs and disease management. 6th edition Baltimore: Williams and Wilkins 1996. pp10-30.
Wenzel PR. Preoperative antibiotics prophylaxis. N Engl J Med 1992; 32:337-9.
Lindblad WJ. The considerations of determining if a natural product is an effective wound healing agent. Int J low Extrem wounds 2008; 7:73-81.
Forrest RD. Early history of wound treatment. J R Soc Med 1992; 75:198-205.
Foster W, Raoult A. Early description of antibiosis. J R Coll Gen Pract 1974; 24:889-94.
Waksman SA. What is antibiotic substance? Mycolia 1947; 39:565-9.
Bosch F, Rosich L. The contributions of Paul Ehrlich: a tribute on the occasion of the centenary of his noble prize. Pharmacology 2008; 82:171-9.
Burke JF. The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surg 1961; 50:160-8.
Talon D, Mourey F, Tourgtier S, Marie O, Arlet G. Evaluation of current practices in surgical antimicrobial prophylaxis before and after implementation of local guidelines. J Hosp Infect -2001; 49:193-8.
Gorbash SL. Evaluation of new anti-infective drugs for surgical prophylaxis. Clin. Infect. Dis 1992; 15: 313-38.
Page CP, Bohen JM, Fletcher JR, Mcmanus AT, Solomon JS, Wittman DH. Antimicrbial prophylaxis for surgical wounds in Guidelines for clinical care. Arch Surg 1993; 128:78-88.
Shapiro M, Townsend TR, Rosner B. Use of antimicrobial drugs in general hospitals: Patterns of prophylaxis. N Engl J Med 1979; 301:351-5.
Gottrup F. Prevention of surgical wound infections. N Engl J Med 2000; 324:202-.Osuigwe AN, Ekwunife CN, Ihekwoba CH. Use of prophylactic antibiotics in paediatric day case surgery at NAUTH Nnewi Nigeria: A randomized double blind study. Trop. Doct 2006; 36:42-4.
Usang UE, Sowande OA, Adejuigbe O, Bakare TI, Ademuyiwa OA. The role of preoperative antibiotics in the prevention of wound infection after day case surgery for inguinal hernia in children at Ile-Ife, Nigeria. Paediatr Surg Int 2008; 10:1181-5.
Magram AJ, Horan TC, Mitchele LP, William RJ. Guideline for prevention of surgical site infection. Infect. Control Hosp. Epidemiol. 1999; 20:247.
Kessler RW, Guhlow LT, Saulsbury FT. Prophylactic antibiotics in paediatric surgery. Paeditrics 1982; 68:1-3.[
.Berrios-Torres SI, Umscheid CA, Bratzer DW. Center of disease control and prevention guidelines for prevention of surgical site infection JAMA Surg 2017
Bratzler WD, Dellinger PE, Olsen KM, Peri TM. ASHP therapeutic guidelines on Antimicrobial prophylaxis in surgery. Am J Health-Syst. Pharm 2013; 70: 195-283.
Dudgeon DC, Anderson KD, Aschcraft KW, Boeckman CR, Ellis DG, Fonkalsrud et al. Antibiotics prophylaxis in paediatric surgical patients. Paediatrics 1984:74-9.
Hirschmann JV, Inui TS. Antimicrobial prophylaxis. A critique of recent trials. Rev Infect Dis 1980; 2:1-23.
Miles AA, Miles EM, Burke J. The value and defense reactions of the skin to the primary lodgment of bacteria. Br J Exp Pathol. 1957; 38: 79-96.
Nagvi SH, Dunkle HM, Timmerman KJ. Antibiotic usage in a paediatric medical centre. JAMA 1979; 242:1981-4.
Schollenberg E, Abritton WL. Antibiotic misuse in a paediatric teaching hospital. Can Med Assoc J 1980; 122:49-52.
Ameh EA, Mshelbwala PM, Nasir AA, Lukong CS, Jabo BA, Anumah et al. Surgical site infection in children: prospective analysis of the burden and risk factors in a sub-Saharan African setting. Surg Infect. 2009 10(2):105-9.
.Jawetz E. Penicillins and cephalosporins. In: Katzung BG (Editor) Basic and Clinical Pharmacology. 6th edition Connecticut Appleton and Lange 1992 pp680-6.
.Sathian B, Sreedharam J, Baboo NS. Relevance of sample size determination in medical research. NepJOL. 2010; 1:4-10/
Diener-West M. Use of Chi Square statistics. John Hopkins 2008; pp1-42.
Goyal RC. Research Methodology for Health Professionals. New Delhi, Jaypee 2013; pp165-7.
Abdur-Rahmann LO, Kolawale IK, Adeniran AA. Paediatric day case surgery: Experience from tertiary health institution in Nigeria. Ann Afr Med. Vol 8 2009; 163-7.
.Salder GP, Watkins G, Richard H, Foster ME. Day case paediatric surgery: the only choice. An R Coll Surg Engl 1992; 130-3.
Calder F, Hurley p, Fernandez C. Paediatric day case surgery in a district general hospital: a safe option. Ann R Coll Surg Engl 2001; 1:83.
Bronsther B, Abrams MW, Elboim C. Inguinal hernias in children-a study of 1000 cases and a review of the literature. J Am Med Women Assoc 1972; S27:522-52.
.Yousuf M, Hussain M. Need and duration of antibiotic therapy in clean and clean contaminated. JPMA 2000; Jul: 284-7.
Anaya DA, Dellinger EP. Surgical infections and choice of antibiotics. In: Townsend CM. Beauchamp RD, Evers BM, Mattox KL (Editors). Sabiston Textbook of Surgery 17th edition. Philadephia. W B Saunders company 2004. Pp257-82.
Cuschieeri SA, Steele RJ. Patients undergoing surgery. In: Cuscheeri SA, Steele RJ, Moosa AR (Editors). Essentials Surgical practice. 4th edition. Oxford. Arnold 2000 pp372-3.
.Bhatti HA, Shadid A, Ahmad T, Qurehi. Role of antibiotics in clean surgery. Paskistan Postgrad. Med. J 2000; 11:87-8.
.Khan N, Chemoprophylaxis in operative cases. Parkistan Armed Forces Med J. 1998; 12:40-5.
Mishiru SF, Law DJ, Jeffrey PJ. Factors affecting the incidence of post-operative wound infection. J. Hosp. Infect. 1990; 16:223-30.