Single Dose Prophylaxis in Obstetrics and Gynaecological Surgeries

Abstract

Objective:  To evaluate the effectiveness of single dose prophylaxis in elective obstetric and gynecologic surgeries.

Study Design:  Descriptive study.

Place and Duration of Study:  Department of obstetric and Gynae, Sharif Medical and Dental College/Hospital Lahore from January 2006 to August 2008.

Patients and Method:  A prospective study comprising of 305 patients undergoing elective obst and Gynecologic surgery during a period of 3 years at department of obstetric and Gynae, Sharif Medical and Dental College/Hospital Lahore. All patients received 1.5 gm parental cefurexime at the time of induction of anesthesia. Hospital and post discharge surveillance for presence of surgical site wound infection was done.

Results:  In this study, Total 305 patients were enrolled, 249 were obstetric and 56 were gynecologic patients. No intra-operative surgical complication was observed with 54.91mins mean surgical duration. Febrile morbidity was seen in 91 patients (30%) and only 10 patients were developed infectious morbidity irrespective of Hb level. The mean duration of hospital stay was 3.56 days.

Conclusion:  The use of single dose preoperative cefurexime prophylaxis was as effective as multidose regimes for preventing serious infectious morbidity among our patients. It's the maintenance of standard sterilization techniques of operation room which counts not the nutritional status or Hb level for the prevention of surgical site wound infection.   Shortening the duration of antibiotic prophylaxis also helps in reduction of medical costs.

Key Words:  Antibiotic prophylaxis, cefurexime, gynecologic surgery, surgical site, wound infection.