Introduction: This prospective cross sectional study assessed surgical antibiotic prophylaxis (SAP) practice,
the incidence of surgical site infection (SSI) and its associated risks in Universiti Kebangsaan Malaysia Medical
Centre. Methods: Patients for elective colorectal, hepatobiliary, upper gastrointestinal, breast and
endocrine surgery, who received SAP were included and followed up until day-30 postoperatively. Types of
antibiotic, preoperative–dose timing, intraoperative re-dosing and its duration were recorded. The incidence
of SSI was calculated and its associated risks expressed in odds ratio. Results: Out of 166 patients recruited,
121 (72.89%) patients received SAP preoperatively, and 91 (75.21%) of them were prescribed the appropriate
antibiotic as per our institutional guideline. Three patients who continued to receive therapeutic antibiotic
postoperatively were excluded from statistical analysis. Eleven (9.10%) patients received SAP beyond the
preoperative–dose timing of 60 minutes (p=0.001), which was an independent risk factor for SSI (adjusted OR
4.527, 95% CI; 1.058-19.367, p=0.042). The risk of SSI also remained in patients who continued to receive
SAP beyond 24 hours (OR 4.667, 95% CI; 1.527-14.259, p=0.007). The overall rate of SSI was 17.18%.
Conclusion: We found that the choice of antibiotic prescribed for SAP was in accordance to institutional
guideline and the relatively high SSI incidence was similar to a recent local report. Although the number of
patients receiving preoperative dose-timing of > 60 minutes was low, it was nonetheless an independent risk
factor for SSI. The postoperative continuation of SAP for more than 24 hours showed no benefit in reducing
SSI.
This prospective cross sectional studyassessed surgical antibiotic prophylaxis (SAP) practice, the incidence of surgical site infection (SSI) and its associated risks in Universiti Kebangsaan Malaysia Medical Centre. Methods: Patients for elective colorectal, hepatobiliary, upper gastrointestinal, breast and endocrine surgery, who received SAP were includedand followed up until day-30 postoperatively. Types of antibiotic, preoperative–dose timing, intraoperative re-dosing and its duration were recorded. The incidence of SSI was calculated and its associated risks expressed in odds ratio.Results: Out of 166 patients recruited, 121 (72.89%) patients received SAP preoperatively, and 91 (75.21%) of them were prescribed the appropriate antibiotic as per our institutional guideline. Three patients who continued to receive therapeutic antibiotic postoperatively were excluded from statistical analysis. Eleven (9.10%) patients received SAP beyond the preoperative–dose timing of 60 minutes (p=0.001), which was an independent risk factor for SSI (adjusted OR 4.527, 95% CI; 1.058-19.367, p=0.042). The risk of SSI also remained in patients who continued to receive SAP beyond 24 hours (OR 4.667, 95% CI; 1.527-14.259, p=0.007). The overall rate of SSI was 17.18%. Conclusion:We found that the choice of antibiotic prescribed for SAP was in accordance to institutional guideline and the relatively high SSI incidence was similar to a recent local report. Although the number of patients receiving preoperative dose-timing of > 60 minutes was low, it was nonetheless an independent risk factor for SSI. The postoperative continuation of SAP for more than 24 hours showed no benefit in reducing SSI.