A comparative study between a single-dose and 24-hour multiple-dose antibiotic prophylaxis for elective hysterectomy

  • Khalid Mohammed Akkour Department of Obstetrics and Gynecology, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia
  • Maria Abdulrahim Arafah Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • Mais Mohammed Alhulwah Department of Obstetrics and Gynecology, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia
  • Rana Saeed Badaghish Department of Obstetrics and Gynecology, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia
  • Hani Abdulmohsen Alhalal Department of Obstetrics and Gynecology, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia
  • Nada Mohammed Alayed Department of Obstetrics and Gynecology, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia
  • Sarah Batel Alqahtani Infection Control Department, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia
  • Shazia Shahzad Ahmad Iqbal Faculty of Medicine, Alfarabi College of Medicine, Riyadh, Saudi Arabia
Keywords: Antibiotics, cefazolin, hysterectomy, prophylaxis, surgical, site infections, SSI

Abstract

Introduction: Surgical site infections (SSIs) are a major health issue in surgical specialties in terms of health care costs and patients’ clinical outcomes. At the level of the patient, prolonged hospital stays or readmissions for SSIs, can affect the patient’s quality of life. At the level of the health care system, it exhausts the hospital’s resources and increases the burden on the medical staff due to the need for continuous wound care, microbiological cultures, laboratory tests and medications. In this study, we assessed the effectiveness of two antibiotic prophylaxis regimens for the prevention of SSIs in patients undergoing elective hysterectomy surgeries.

Methodology: A retrospective cohort, analyzing 141 patients, was conducted between November 2016 and January 2019 at a university hospital. We compared the efficacy of a single dose vs. 24-hour multiple doses of Cefazolin in patients who underwent elective hysterectomy for benign or malignant indications. The secondary objective was to identify potential risk factors associated with SSIs.

Results: There was no statistically significant difference between both groups (p = 0.872). Obesity and a laparotomy surgical approach are risk factors to the development of SSIs (p = 0.001 and 0.014, respectively). Other potential risk factors include the duration of hospital stay, the duration of the surgery and the amount of blood loss.

Conclusions: Although the rate of SSIs is not significantly different between both groups, risk stratification can be done after screening patients and the prophylactic regimen must be tailored for each patient in a cost-effective manner and using a multidisciplinary approach.

Author Biographies

Khalid Mohammed Akkour, Department of Obstetrics and Gynecology, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia

Consultant and Assistant professor

Department of Obstetrics and Gynecology, College of Medicine

Maria Abdulrahim Arafah, Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Consultant and Associate professor

Department of Pathology, College of Medicine

Mais Mohammed Alhulwah, Department of Obstetrics and Gynecology, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia

Resident

Department of Obstetrics and Gynecology, College of Medicine

Rana Saeed Badaghish, Department of Obstetrics and Gynecology, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia

Department of Obstetrics and Gynecology, College of Medicine

Hani Abdulmohsen Alhalal, Department of Obstetrics and Gynecology, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia

Consultant

Department of Obstetrics and Gynecology, College of Medicine,

Nada Mohammed Alayed, Department of Obstetrics and Gynecology, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia

Consultant and Assistant professor

Department of Obstetrics and Gynecology, College of Medicine,

Sarah Batel Alqahtani, Infection Control Department, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia

Infection Control Department, College of Medicine

Published
2020-11-30
How to Cite
1.
Akkour KM, Arafah MA, Alhulwah MM, Badaghish RS, Alhalal HA, Alayed NM, Alqahtani SB, Iqbal SSA (2020) A comparative study between a single-dose and 24-hour multiple-dose antibiotic prophylaxis for elective hysterectomy. J Infect Dev Ctries 14:1306-1313. doi: 10.3855/jidc.13034
Section
Original Articles