Efficacy of short term versus long term antibiotic therapy in preventing deep wound infections in elective orthopaedic surgeries

Background: Comparison of the efficacy of short term (up to 48 hours) versus long term (five days) antibiotic therapy in preventing deep wound infections in elective orthopaedic surgeries. Methods: Two hundred patients of all ages and both sexes were divided into two groups of 100 patients. One group received long term antibiotic treatment consisting of 2 days intra-venous cefoperazone sulbactam 1.5 gm twice daily and intra-venous amikacin 500 mg twice daily followed by 3 days of oral amoxicillin clavulunate 625 mg thrice daily. Other group received short term antibiotic of 2 days intra-venous cefoperazone sulbactam 1.5 gm twice daily and intra-venous amikacin 500 mg twice daily. Comparison of SSI was done with age, sex, BMI, pre-operative haemoglobin, TLC, duration of surgery in both the groups. Results: In group I and group II respectively, average duration of surgery in procedures involving implants was 65.02±27.41 and 59.47±20.27 minutes and non implant related procedures was 53.66±23.97 and 53.74±22.40 minutes. Overall incidence of SSI in Group I and Group II was 14% and 10% respectively. Mean infection in the present study was 12%. Conclusions: It was concluded that in clean orthopaedic elective surgeries short term antibiotics regimen is as effective as long term antibiotics regimen. Continuing antibiotics for more than two days is associated with drug related complications like allergic reactions and gastrointestinal upset, adverse interactions in other drugs, development of resistant organisms and it adds to overall cost of treatment.