Postoperative Outcome of Single Dose Vs Multiple Doses of Prophylactic Antibiotics in Major Elective Obstetric and Gynecological Surgeries: A Prospective Observational Study

Antibiotic prophylaxis is a well established entity in current medical practice for prevention of SSI, urinary tract infection (UTI), endometritis and other complications related to surgery, developing as a result of invasion by bacteria or other pathogens. Patterns of use of antibiotic prophylaxis in pioneer health care institutes have been studied and it has been found that about 30-90 % of total use of antibiotics in hospitals is inappropriate in terms of choice of antibiotic, dose and timing. Many studies support the use of single dose of prophylactic antibiotics over multiple doses. But in practice multiple dose regimens are being frequently used. Major complication arising out of the situation is antimicrobial resistance. Ineffective older antibiotics leading to the need for newer and stronger antibiotics pose a huge financial as well as pathological burden on society. Our study aimed at comparing the effect of single dose with that of multiple doses of prophylactic antibiotics in major elective obstetric and gynaecological surgery. This prospective observational study was conducted at department of obstetrics and gynecology at Indraprastha Apollo Hospitals, New Delhi, India from August 2015 till December 2016. A total of 400 patients (200 in each group) admitted for major obstetric and gynecological surgeries were studied at the time of discharge, 1week and 1month after the surgery. No significant difference was found in rates of surgical site infections (SSI), febrile illness, urinary tract infection (UTI), and chest infection, while a significant increase was found in rate of injection site inflammation in those receiving multiple dose regime of prophylactic antibiotics.