Antibiotic use and abuse in clean and clean-contaminated operations

الملخص EN

Background : A prophylactic antibiotic regimen may not be successful the drug is not effective against all potential pathogens or if the agent does not come in contact with susceptible pathogen at the site of infection.

Aim Of The Study : the aim of this study is to evaluate the patients and procedures for which antibiotics were prescribed as prophylactic manner.

Method: Intravenous cefotaxime sodium as a prophylaxis was used in 49 patients (65.3 %) were underwent elective and emergency clean-contaminated operations.

Were given three doses prophylaxis antibiotics, first dose before induction of anesthesia (30-60 Minutes) and subsequent two doses given at 8 hours interval post operatively, those patients were group(A) in the study, while group(B) 26 patients (34.6 %) clean operations not receiving antibiotics and 75 patients group (C) those treated by systemic therapeutic antibiotics.

Postoperative hospital stay of all patients was not more than five days.

Evidence of wound infection was observed 2 weeks postoperatively in surgical outpatient department in study and control groups.

Results : In group (A) six patients (12.24 %) have grade III surgical site infection treated by surgical intervention and antibiotics administration according to culture and sensitivity ,in group (B) one patient (3.48 %) develop grade I surgical site infection and one patient (3.48 %) developed grade III surgical site infection, in group (C) treated by systemic antibiotics regardless the type of surgical operations whether clean or clean-contaminated, six patients (8 %) develop grade I surgical site infection while 26 patients 34.6 % developed grade III surgical site infection.

Conclusion : Choosing third generation cephalosporin (one gram cefotaxime) as a prophylactic antibiotic for clean-contaminated operations, because its available ,less expensive, broad spectrum also act against anaerobic infections and more reliable method to prevent surgical site infections.