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Antibiotics for preventing infection at the surgical site: Single dose vs. multiple doses

Nehad J Ahmed1,2, Abdul Haseeb3, Abdullmoin AlQarni4

  • 1Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.

Saudi Pharmaceutical Journal : SPJ : the Official Publication of the Saudi Pharmaceutical Society
|November 29, 2023
PubMed
Abstract

Insights

A single dose of antibiotic prophylaxis is as effective as multiple doses in preventing surgical site infections. This finding supports optimizing antibiotic use to reduce costs and combat antimicrobial resistance.

Area of Science:

  • Infectious Diseases
  • Surgical Outcomes
  • Pharmacoeconomics

Background:

  • Surgical site infections (SSIs) are a significant cause of patient morbidity and healthcare costs.
  • Antibiotic prophylaxis is standard for SSI prevention, but overuse contributes to resistance and expense.
  • Optimizing antibiotic regimens is crucial for effective infection control and antimicrobial stewardship.

Purpose of the Study:

  • To compare the efficacy of single-dose versus multiple-dose antibiotic prophylaxis in preventing SSIs.
  • To evaluate the impact of antibiotic dosing strategies on SSI rates across different surgical wound classifications.

Main Methods:

  • A meta-analysis of 74 clinical trials published between 1984 and 2022 was conducted.
  • Data from 11,611 patients in single-dose groups and 11,188 patients in multiple-dose groups were analyzed.
  • Odds ratios (OR) with 95% confidence intervals were calculated to compare SSI incidence, using Review Manager (RevMan 5.4).

Main Results:

  • Overall, single-dose prophylaxis showed an SSI rate of 7.13% compared to 6.81% for multiple doses (OR = 1.05, 95% CI: 0.93–1.20), with no statistically significant difference.
  • Analysis by wound classification (clean, clean-contaminated, contaminated) also revealed no significant differences between single and multiple antibiotic doses.
  • The observed rates of surgical site infections were comparable across both dosing strategies.

Conclusions:

  • Single-dose antibiotic prophylaxis is as effective as multiple doses for preventing surgical site infections.
  • This supports the use of single-dose regimens to optimize antibiotic use, reduce costs, and mitigate antimicrobial resistance.
  • Findings advocate for evidence-based antibiotic stewardship in surgical settings.
Keywords:
AntibioticsClinical TrialsMultiple DosesSingle DoseSurgical Site Infections

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