Surgical site infection in Nigerian patients: A comparative study of two prophylactic antibiotics

Abstract

Background: Infection remains an important complication of surgical procedures. It is an important aspect of patient care as it can be a source of distress for the patients, and the healthcare system in terms of finance and psychological impact. The administration of appropriate prophylactic antibiotics is important in the prevention of surgical site infection (SSI). However, resistance to antibiotics by the micro-organisms is a growing concern in the healthcare industry. This study compared the infection rate between Ceftriaxone and Ceftriaxone-Tazobactam combination as surgical prophylaxis in Nigerian population. Method: This was a double blinded randomized study conducted at the Lagos University Teaching Hospital from October 2020 to September2021. Two hundred and forty (240) patients ,who were to have surgical procedures performed on them, were recruited and randomly distributed into two groups (A&B) of 120 patients each. Group A were those who had Ceftriaxone alone ,while group B were those who had combination of Ceftriaxone and Tazobactam. Results: There was no statistical difference in the demographic characteristics of the two groups .The crude infection rate was 3 .8 %. The infection rate in group A was 3 .3 % within the first week but increased to 4 .2 % in the second week. The infection rate in group B was 3 .3 % within the first week and second week. At 30 days, the infection rate within group A was 2 .5 % and 0 % in group B. Regression analysis showed advanced age (P =0 .003), level of education (P =0 .0001),prolonged duration of surgery (P =0 .012) and excessive blood loss (P =0 .0001) as the important factors associated with development of SSI in the patients included in the study. Conclusion: Surgical site infection remains an important complication following surgeries. Certain factors such as advanced age, prolonged surgery and excessive blood loss increase the risk for SSI. Efforts should be geared towards prevention of SSI in patients by modifying risk factors that are modifiable and using antibiotics with better infection rate as prophylaxis.