Anu Sandhya, Surrendar Dawani, Shahid Rasul, Mansab Ali, Umair-ul Islam.
Antibiotic prophylaxis in mesh repair of inguinal hernia.
Pak J Surg Jan ;29(3):211-5.

Objective: To determine the frequency of wound infection in patients undergoing mesh inguinal hernioplasty, receiving oral antibiotic versus injectable antibiotic prophylaxis. Methods: A total of 100 patients admitt ed in the departments of General Surgery meeting the inclusion and exclusion criteria were included in this study. A writt en consent was obtained by the patient. All the patients were undergone Mesh repair for hernia by a consultant general surgeon or senior registrar as per hospital protocols having more than 2 years of postfellowship experience. Th e patients were divided in two groups, group A received a single intravenous dose of Injection Amoxicillin-Clavulinic Acid 1.2gms at the time of induction of anesthesia. Group B were asked to take a single oral dose Tablet Amoxicllin-Clavulanic Acid 1gm 3 hours prior to surgery. Results: Th e mean age of patients in group A was 46.55 +/- 1.96 years with male/female ratio of 20/5, while the mean age of patients in group B was 43.55 +/- 3.03. Five of the total 100 patients developed superfi cial SSIs. Th e incidence of SSI in group A (parenteral) was 4%(2 cases), whereas that in group B (oral) was 6% (3 cases). Th e cost of oral amoxicillin–clavulanic acid prophylaxis at a dose of 1.2 g is 25 Pakistani rupees, whereas the cost of 1 g of the parenteral form is 150 Pakistani rupees. Conclusion: Based on the results, we conclude that oral amoxicillin–clavulanic prophylaxis is simple and safe to use in this patient group, and that the oral route is as effi cacious as parenteral administration in preventing SSIs. Furthermore, a basic cost analysis indicates that oral antibiotic prophylaxis with this combination is less than half as expensive as parenteral treatment.

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