Postcircumcision surgical site infection is not related to antibiotic use: a retrospective cohort in an indonesian teaching hospital

Abstract

BACKGROUND: Male child circumcision is commonly practiced among male children in Indonesia, and broad-spectrum antibiotics, either oral or topical, are often used to prevent surgical site infections. However, various guidelines suggest not using oral antibiotics as a prophylactic in male child circumcision. This study aimed to determine the incidence of surgical site infection after circumcision without oral antibiotics, following the guidelines, at the Universitas Indonesia Hospital.METHODS: This study included all male child circumcision with and without antibiotics at RSUI between 2018 and 2019. The circumcisions were followed up for 30 days to assess whether or not the post-circumcision infection occurred. A total of 92 patients with 0-12 years old range of age and 28 patients with an abnormal penis undergoing circumcision were required to assess the association between antibiotic uses in circumcision and the postoperative infection incidence. In addition, the associations were tested with Chi-square tests and relative risk.RESULTS: Of the 92 male children undergoing circumcision, 69 took antibiotics, and 23 did not; 7 patients (7.6%) had post-circumcision surgical site infections. Of those with infections, most infections occurred within 7-30 postoperative days (5.4%) and remained for 1-2 weeks (4.3%). The infection developed in 13% of children with oral and topical antibiotics and 5.7% of children who received topical antibiotics alone. There was no significant association between antibiotic use for circumcision and the incidence of surgical site infection (P=0.35; RR = 0,25; 95% CI = 0.54 -12.67).CONCLUSIONS: Post-circumcision surgical site infection is not significantly related to oral antibiotic use. Therefore, oral antibiotics following male children’s circumcision should be limited to only those at risk of developing an infection.