Comparison of single dose and extended dose antibiotics for prevention of surgical site infections in elective cesarean section at a tertiary hospital in Western Kenya: A randomized control trial

Abstract

Background: Cesarean sections (CS) account for most recorded cases of surgical site infections (SSI), occurring in one-third to two-thirds of operated patients in low-income nations. It is not clear from previous studies whether there exists any significant difference in prevention of SSI when single dose prophylaxis is used compared to extended dose antibiotics.

Objective: To evaluate differences in occurrence of SSI among women undergoing elective CS when single dose antibiotics is used for prophylaxis compared to extended antibiotics.

Methods: This was an unblinded randomized control study carried out at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). A total of 150 women between 18 to 49 years of age who underwent elective CS and received either single dose of ceftriaxone or extended dose of ceftriaxone and metronidazole. Follow up for 28 days for evidence of SSIs on days 1, 2, 14 and 28 after surgery was done. The data collected was summarized using frequency counts and percentages. Inferential analysis employed were Pearson’s Chi-square test of independence and binary logistics regression analysis. Covariates with p-value < 0.05 were considered significant.

Results: The two groups were comparable in sociodemographic characteristics. A total of 3 (2%) respondents developed SSI, 2 (1.3%) from the single dose arm and 1(0.7%) from the extended dose arm. This difference was not statistically significant (P value 0.567 CI 0.044 – 5.559; OR 0.493)

Conclusion: Single dose antibiotic is as effective as extended dose of antibiotics in prevention of surgical site infection in women undergoing elective cesarean section at JOOTRH.