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Main Article Content
Antibiotic prophylaxis in obstetric and gynaecological procedures: Acomparative study between two regimens of antibiotics
Abstract
Background: Postoperative wound infections have an enormous impact on the quality of life and contribute substantially to the financial cost of patient care. The study aims to compare the clinical efficacy of two perioperative/postoperative antibiotic regimens, the wound outcome and difference in cost on healthcare between these regimens.
Methods: This is an observational prospective cohort study of 290 women. Women scheduled for elective surgeries in the department were grouped to have either a combination of ampicillin/cloxacillin (Ampiclox), Gentamicin, and Metronidazole (triple regimen) or a combination of ceftriaxone and metronidazole (double regimen). Data was analysed using Statistical Package for Social Science (SPSS) Windows version 21. The wound outcome and the cost implication of the antibiotic regimen were compared by chi-square test and t-test as appropriate. A p-value less than 0.05 was considered significant.
Results: The postoperative wound infection rate in this study was 7.24%. There was no statistical significant difference in postoperative infection in the triple regimen group compared to the double regimen group. However, there was a significantly longer duration of stay in the hospital in the triple regimen group (P <0.05). There was also a statistical significant difference in the cost of hospital stay and the cost of antibiotics in the triple regimen group (P<0.05). There was no statistically significant difference in the pattern of organisms cultured in both groups.
Conclusions: Ceftriaxone/Metronidazole regime of antibiotics showed superiority over ampicillin/cloxacillin, Metronidazole, and Gentamicin in the prevention of postoperative wound infection, hospital stay, and reduced cost of healthcare.
French title: Prophylaxie antibiotique dans les procédures obstétricales et gynécologiques : une étude comparative entre deux schémas thérapeutiques antibiotiques
Contexte de l'étude: Les infections postopératoires des plaies ont un impact énorme sur la qualité de vie et contribuent considérablement au coût financier des soins aux patients. L'étude vise à comparer l'efficacité clinique de deux régimes antibiotiques péri opératoires/postopératoires, l'issue de la plaie et la différence de coût des soins de santé entre ces régimes.
Paramètres et conception : Il s'agit d'une étude de cohorte prospective observationnelle portant sur 290 femmes. Les femmes devant subir des interventions chirurgicales électives dans le département ont été regroupées pour recevoir soit une combinaison d'ampicilline/ cloxacilline (Ampiclox), de gentamicine et de métronidazole (triple régime), soit une combinaison de ceftriaxone et de métronidazole (double régime).
Analyse statistique : les données ont été analysées à l'aide du progiciel statistique pour les sciences sociales (PSSS) Windows version 21. L'issue de la plaie et les implications financières du régime antibiotique ont été comparées par le test du chi carré et le test t, le cas échéant. Une valeur p inférieure à 0,05 était considérée comme significative.
Résultats de l'étude : Le taux d'infection des plaies postopératoires dans cette étude était de 7,24 %. Il n'y avait pas de différence statistiquement significative en termes d'infection postopératoire dans le groupe à triple régime par rapport au groupe à double régime. Cependant, la durée de séjour à l'hôpital était significativement plus longue dans le groupe triple régime (P<0,05). Il y avait également une différence statistiquement significative dans le coût du séjour à l'hôpital et le coût des antibiotiques dans le groupe triple régime ( P <0,05) . Il n'y avait pas de différence statistiquement significative dans le modèle d'organismes cultivés dans les deux groupes.
Conclusion: Le régime d'antibiotiques Ceftriaxone/métronidazole a montré une supériorité sur l'ampicilline/cloxacilline,le métronidazole et la gentamicine dans la prévention de l'infection postopératoire des plaies, du séjour à l'hôpital et de la réduction du coût des soins de santé.
