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Abstract

BSTRACT: BACKGROUND: Surgical site infection is one of the commonest complications after surgical operations and the use of antibiotics in preventing or reducing infection is associated with many problems. OBJECTIVE: To evaluate the use of peri- operative prophylactic antibiotics in preventing or reducing surgical site infection in different types of operations PATIENTS AND METHODS: This prospective study was conducted on(560) patients from June 2002 to January 2007 in general surgical department in Baghdad teaching hospital. The patients were divided into( 3) groups according to the type of operation; clean operations which included 200 patients, clean-contaminated operations which included 160 patients and contaminated operations which included 200 patients) and they were further subdivided into 2 groups, group A of patients were treated with peri operative prophylactic Cefotaxime antibiotic while the group B patients were treated with therapeutic dose of the same antibiotic for prolonged duration (5 days). Those patients were followed up for 4 weeks after operation and when signs of wound infection appeared, swab for culture and sensitivity was taken to determine the type of bacteria, and effective antibiotics against them. RESULT: Result showed that (3) patients (3%) in clean surgery developed wound infection when using perioperative regimen as compared to( 2) patients (2%) when using therapeutic regimen. In clean contaminated wounds infection appeared in (5) patients (5%) in patients using prophylactic or postoperative regimen while in contaminated wounds, (11) patients (11%) developed wound infection when using perioperative regimen as compared to( 6) patients (6%) who developed wound infection in patients using postoperative antibiotics. Statistically, there is little difference in effectiveness of the two regimens (A and B) in both group( 1) and( 2) operations but in the group( 3) operations, although prophylactic antibiotic regimen reduced the infection rate to 11% but it was not as effective as the therapeutic regimen in reducing wound infection (6%) . CONCLUSION: Postoperative antibiotics should be resisted in clean and clean contaminated operations instead perioperative antibiotics can be used, and prolonged postoperative antibiotics should be used only in contaminated operations

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