Correlation of infection of surgical wounds with preoperative antibiotic usage in a tertiary care hospital

Appropriately administered antibiotic prophylaxis reduces the incidence of surgical wound infection. Prophylaxis is uniformly recommended for all clean-contaminated, contaminated and dirty procedures. Methodolgy The study was conducted in the department of microbiology , Medical College Calicut for a period of one year from july 2007 to june 2008. The total number of elective and emergency surgeries done during the one year period in the above three units was 1902 which included 1074 elective (major) and 828 emergency cases. One hundred and two cases of clinically suspected postoperative wound infection (Fifty nine elective and fourty three emergency) from the above cases was studied in detail. The study included twenty seven 'clean', thirty two 'clean-contaminated' , thirteen 'contaminated' and thirty 'dirty' cases. Records of these cases were analysed for preoperative antibiotic prophylaxis .Results Ampicillin was given as the prophylactic antibiotic in majority of the cases (17/27) in this 'clean' category. Two patients developed infection while on preoperative Ampicillin .The infection rate was 12% with ampicillin . in clean-contaminated and contaminated surgeries majority of patients received combinations of cefotaxime (1gm)plus Metronidazole(500mg). Majority of dirty group (15/30) received combination of Cefotaxime plus Metronidazole and seven of the fifteen(47%) on this combination developed infection. Conclusion Antibiotics are used widely for the prophylaxis of surgical infections. This study has examined the use of different antibiotics and its combinations in prophylaxis and treatment of postoperative wound infections.Appropriately administered antibiotic prophylaxis reduces the incidence of surgical wound infection. Prophylaxis is uniformly recommended for all clean-contaminated, contaminated and dirty procedures. It is considered optional for most clean procedures although it may be indicated for certain patients and clean procedures that fulfill specific risk criteria.