Abstract | OBJECTIVE: DESIGN: Randomized, double-blind clinical trial. SETTING: Saint Paul General Hospital, Coquimbo, Chile, during a period when it was undergoing significant interior remodeling. PATIENTS: General surgery patients who received antibiotic prophylaxis before clean wound surgery between March 2003 and May 2004 and a matched control group of patients who did not receive such prophylaxis. RESULTS: A total of 303 patients participated in the study. The rate of infection among patients with an American Society of Anesthesiologists (ASA) classification of 1 in the prophylaxis group was 7.3%, whereas among ASA 1 patients in a no-prophylaxis control group it was 10.3% (P=.40). In the prophylaxis group, the ASA 2 and ASA 3 patients combined had an infection rate of 10.5%, whereas in the no-prophylaxis group these patients had a rate of 30.0% (relative risk, 0.33 [95% confidence interval, 0.58-0.96]; P=.03). Both the ASA 2 and ASA 3 patients were protected from infection by prophylaxis; these patients had 1.7 and 2.2 times, respectively, more risk of developing a surgical site infection than did ASA 1 patients after a clean surgical procedure, but the ASA 2 and ASA 3 patients who did not receive prophylaxis had 4.3 and 4.8 times, respectively, greater risk of infection (relative risk, 0.91 [95% confidence interval, 0.83-0.99]; P=.02). Prophylaxis significantly reduced the rate of infection in the ASA 2 and ASA 3 groups. CONCLUSIONS: We recommend the use of antimicrobial prophylaxis with cephalosporins in ASA 2 and ASA 3 patients undergoing clean wound surgery during a period when significant renovations are being performed in the hospital.
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Authors | Osvaldo Iribarren, Miguel Araujo |
Journal | Infection control and hospital epidemiology
(Infect Control Hosp Epidemiol)
Vol. 27
Issue 12
Pg. 1372-6
(Dec 2006)
ISSN: 0899-823X [Print] United States |
PMID | 17152037
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Anti-Bacterial Agents
- Cefuroxime
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Topics |
- Anti-Bacterial Agents
(therapeutic use)
- Antibiotic Prophylaxis
- Cefuroxime
(therapeutic use)
- Female
- Hospital Design and Construction
- Humans
- Male
- Middle Aged
- Prospective Studies
- Surgical Wound Infection
(drug therapy, epidemiology, prevention & control)
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