Original Article Annals of International Medical and Dental Research, Vol (1), Issue (1) Page 29 A Prospective Study Comparing Single with Multiple Antibiotic Prophylaxis Dose in Elective Cholecystectomy Rajesh Chaudhary*, Sanjeev Sharma**, Sudarshan Chaudhary***, Sunil Thakur****, Ankit Shukla*, Manjeet Sharma + *Senior Resident, Department of Surgery, RPGMC, Tanda. ** Professor, Department of Surgery, RPGMC, Tanda. *** Professor, Department of Anaesthesia, RPGMC, Tanda ****Consultant, Department of Anaesthesia, VMI, Palampur. + Senior Resident, Department of Urology, IGMC, Shimla. ABSTRACT Background: Cholecystectomy is one of the commonest, clean and contaminated surgery operations performed by the surgeons worldwide. Antibiotic prophylaxis in elective cholecystectomy is a controversial issue and our study was undertaken to evaluate the rate of infection and the usefulness and efficacy of antibiotic prophylaxis in elective cholecystectomies. Methods: The study comprised of 100 patients admitted for elective cholecystectomy. The first fifty patients undergoing elective cholecystectomy were given the prophylactic antibiotic outside the operation theater in the wards and the next fifty patients were given a single dose of injection cefuroxime (1.5 gm i.v). Results: In single dose antibiotic prophylaxis group 10.52% people developed surgical site infection in open cholecystectomy group while patients developed infection in laparoscopic cholecystectomy group but in multiple dose group 16.21% patients who underwent open cholecystectomy developed a surgical site infection while 10% developed an SSI in laparoscopic cholecystectomy group. In both the groups, results are statistically not significant. Conclusion: This study document that one single dose of prophylactic antibiotic, administered at induction of anaesthesia, is sufficient to prevent post-operative infective complications in patients undergoing elective cholecystectomy. Key words: Antibiotic Prophylaxis, Cephalosporin, Elective Cholecystectomy INTRODUCTION A surgical site infection (SSI) is defined as an infection that occurs at or near a surgical incision within 30 days of the procedure or within one year if an implant is left in place . In the twentieth century, the two key factors that have enabled surgical advances, such as open heart surgery and kidney transplants, to become routinely possible and safe are improved anesthesia and scientifically sound infection prevention practices. Despite improvements in operating room practices, instrument sterilization methods, better surgical technique and the best efforts of infection prevention practitioners, SSI remain a major cause of nosocomial (hospital-acquired) infections—and rates are increasing globally. [1] The Centre for Disease Control and Prevention (CDC) estimates that approximately 500,000 SSI occur annually in the United States. [2] They are the leading cause of nosocomial infections after surgery, accounting for nearly 40 percent of nosocomial infections in surgical patients. [3] Name & Address of Corresponding Author Dr. Rajesh Chaudhary Senior Resident, Department of Surgery RPGMC, Tanda, Himachal Pradesh, India. E mail: topgun.chaudhary@gmail.com . Furthermore, patients who develop surgical site infections are five times more likely to be readmitted to the hospital, 60 percent more likely to spend time in the intensive care unit, and twice as likely to die compared with surgical patients without the infections. [4] Cholecystectomy is one of the commonest operations performed by the surgeons worldwide. It being a clean contaminated surgery, use of prophylactic antibiotics (a brief course of an antimicrobial agent administered just before an operation) is mandatory to decrease the incidence of surgical site infections. [3] In many trials worldwide it has been established that the single dose of prophylactic antibiotics is as effective as the multidose regimens. But still out of undue fear of surgical site infections the prophylactic antibiotics are being misused and continued for many days in post operative period adding to the cost burden to the patients as well as drug resistance in the microbes. To reduce the risk of nosocomial SSIs in developing countries, a systematic but realistic approach must be applied with awareness that this risk is influenced by characteristics of the patient, the operation, the healthcare staff and the hospital. Our study aims to observe the surgical site infection rate in patients who are administered single dose prophylactic antibiotics.