Surgical Site Infection among the Patient with Prophylactic Antibiotics in Elective Orthopedic Surgery

Abstract

Introduction: The routine use of prophylactic antibiotics has long been acknowledged to have preventive benefits
in cases of clean orthopaedic surgeries. Although the duration of prophylactic medication has been shortened, the ideal time frame is still unknown. The majority of the surgeons in this country are quite hesitant to employ prophylactic antibiotics for only 24 hrs due to the surrounding environment and theatre conditions, which leads
to serious concerns for the risk of antimicrobial resistance and super-infections. The main aim of the study was to determine the prevalence of surgical site infection among patients who received intravenous antibiotics in elective
orthopaedic surgery.

Methods: The descriptive cross-sectional study was conducted among a total of 90 closed long bone fractures that underwent elective orthopaedic surgeries. They had been given prophylactic intravenous antibiotic ‘Cefuroxime’ for 24 hrs, 3 days, or 5 days, followed by oral Cefuroxime for total antibiotic coverage of 10 days. The patients were followed up on 3rd, 7th, 15th and 30th post-operative days and evaluated for features of surgical site infections. The
point estimate at a 95% Confidence Interval was calculated.

Results: Out of the 90 patients, there were 4 (4.4%) (0.18% to 8.7% at 95% Confidence Interval) cases of surgical site infection. Among them, 1 (3.3%) infection occurred in each 24 hrs group and 1 (3.3%) in the 3 days group and 2 (6.7%) infections occurred in the 5 days group.

Conclusions: The surgical site infection among patient presenting to orthopaedic surgery was lower compared to study done in similar settings. This suggests that a shorter duration of antibiotic prophylaxis, specifically 24 hours, may be just as effective as longer courses in preventing Surgical site infection while reducing the potential risks and
costs associated with extended antibiotic use.