Effectiveness of cefotaxime in preventing surgical site infections in children under 8 years undergoing elective inguinal surgery at the university teaching hospitals, Lusaka, Zambia

Abstract

Inguinal operations are the most commonly 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, Lusaka. 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. 85 of these received pre-operative cefotaxime while 85 did not receive any antibiotics based on surgeons preference. 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 Surgical site infection was done at 2 weeks and 30 days according to Center for Disease Control (CDC) definition of SSI. 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. 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. Keywords: Surgical site infections, Surgical antibiotic prophylaxis, Inguinal surgery, PPV ligation, Herniotomy, Orchidopexy