Effect of Single-Dose Antibiotic Prophylaxis on Surgical Site Infections Following Clean Paediatric Inguinal Surgery

Abstract

Background: In clean surgery, the argument for antibiotic prophylaxis may not be valid, especially for procedures that do not use prosthetic material. The infection rate in such cases is very low. Guidelines specify that the rate of wound infection in clean surgery should not exceed 4%.

Objective: To determine the incidence of surgical-site infection and assess its association with documented single-dose antibiotic prophylaxis among children undergoing clean elective inguinal surgery.

Methods: A prospective cohort study was conducted at the Department of Paediatric Surgery, Shaikh Zayed Medical Complex, Lahore. Consecutive eligible children undergoing clean elective inguinal surgery were enrolled before surgery and followed prospectively for 30 days. Participants were categorized according to whether a single preoperative dose of antibiotic prophylaxis was documented or not as part of routine clinical care. During the one-year study period, 70 eligible children (35 in each group) were enrolled and followed prospectively.

Results: Thirty-five children received a documented single preoperative dose of intravenous cephradine, while 35 did not receive prophylactic antibiotics. Antibiotic-exposed cohort received a single pre-operative dose of intravenous cephradine (50 mg/kg/day), whereas antibiotic-unexposed cohort received no prophylactic antibiotic. There were no statistically significant differences between the antibiotic and no-antibiotic groups. At the 30th postoperative day, 68 (97.2%) patients had grade 0 wounds, with 34 patients in each study group. One surgical-site infection occurred in each cohort.

Conclusion: The use of prophylactic antibiotics in clean paediatric inguinal surgery does not confer any additional benefit for favourable wound outcomes or the prevention of surgical wound infection.