Effectiveness of Cefotaxime in the prevention of surgical site infections in children undergoing elective inguinal surgery at the University Teaching Hospital, Lusaka, Zambia

Abstract

Introduction and objectives: Inguinal operations are the most performed surgeries in children. There is a divergent view on use of pre-operative antibiotic prophylaxis to prevent Surgical site infections (SSI) after these surgeries. The aim of this study was to detect if the use of cefotaxime had a significant impact on prevention of SSI in children under 8 years undergoing elective inguinal surgery at the University Teaching Hospitals (UTHs), Lusaka.

Method: This was a cohort study. A total of 170 patients below 8 years of age undergoing elective inguinal herniotomy, orchidopexy or  patent processus vaginalis (PPV) ligation at UTHs were enrolled. Group A with 85 patients received preoperative cefotaxime while group B with 85 patients did not receive any antibiotics. A data collection sheet was used to record pre-operative demographic details.  Intraoperative variables and post-operative outcomes. No patient received post-operative antibiotics. Follow up to look for SSI was done at 2 weeks and 30 days.

Results: Out of 170 patients, 11(6.47%) had SSI. Six of the 85 that received surgical antibiotic prophylaxis (SAP) had SSI while 5 of the 85 that did not receive SAP had SSI (P=0.551). Deep SSI were seen in 2 patients that did not receive SAP (p=0.155) and grew Staphylococcus aureus in their cultures. Only 1 adverse allergic reaction to preoperative antibiotics was noted.

Conclusion: Despite a low risk of adverse reactions, there is no benefit of using pre-operative antibiotics to prevent SSI in children  undergoing elective inguinal surgery.