Audit of Efficacy of Single-dose Versus Multi-dose Prophylactic Antibiotics in Elective Hernia Repair– A Retrospective Study

Abstract

Background: Elective hernia repairs are associated with a high risk of SSIs that may translate to longer hospital stays and elevated costs. The common practice is the use of prophylactic antibiotics to prevent SSIs, but the right dosage schedule is still in question. To audit the efficacy of single-dose versus multidose prophylactic antibiotics in elective hernia repair.

Material and Methods: This retrospective study was conducted based on data from 183 patients of elective inguinal hernia repairs who received either single-dose or multi-dose antibiotic prophylaxis at a tertiary care teaching hospital from 1st July 2023 to 30th June 2024. Based on inclusion criteria, 80 patients from each group were selected, making a total of 160 patients. The rest of the 23 patients fell into the exclusion criteria and were not included. Patients in group A had been given a preoperative dose of 1g of ceftriaxone before the surgery and group B received the same preoperative dose together with a repeat dose 12 hours after the surgery. This study selected patients aged 18 to 70 years, American Society of Anesthesiologists (ASA) physical status grade I and II, who underwent elective inguinal hernia repair operation. Primary end-points were the rate of SSI and secondary outcomes SAS, hospital length of stay, post-operative complications and antibiotic reactions.

Results: There had been a small decrease in the rate of SSI at day 30 in group B (10%) than in group A (12. 5%); however, the difference was not significant with p = 0. 612. The mean hospital stay and the overall mean days in the hospital, as well as post-operative morbidity such as wound dehiscence and seroma formation, had been comparable in both groups. The two antibiotic regimens chosen were also concluded to be equally safe and effective in reducing SSIs in the hernia-repair population.

Conclusion: This study, therefore, concluded that there were no differences between single-dose prophylactic antibiotics and multiple doses of prophylactic antibiotics for the prevention of surgical site infection (SSI) under elective inguinal hernia repair. The overall rate of SSI, length of how hospital stay and post-operative complications were comparable between both regimens. In total, single-dose prophylaxis seems to be safe and efficient in comparison with multi-dose regimens for hernia repair surgery.