Impact of reduced pre-incision antibiotic infusion time on surgical site infection rates: A prospective observational study.

Piyush Kumar  Sinha; Kritika  Jha; Pankaj Kumar  Mishra; Binoy  Kumar

doi:10.51168/sjhrafrica.v7i3.2602

Authors

Piyush Kumar Sinha Senior resident, Department of General surgery, Patna Medical College & Hospital, Patna, Bihar
Kritika Jha Senior Resident, Department of General surgery, Patna Medical College & Hospital, Patna, Bihar
Pankaj Kumar Mishra Associate Professor, Department of General Surgery, Patna Medical Hospital, Patna, Bihar
Binoy Kumar Professor (HOD), Department of General Surgery, Patna Medical College & Hospital, Patna, Bihar

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2602

Keywords:

Minimised pre-incision, antibiotic administration, SSI rates, standard surgical protocols, surgical site infections

Abstract

Background:
Surgical site infections (SSIs) continue to be a significant contributor to postoperative morbidity, resulting in extended hospitalisations, elevated healthcare expenses, and detrimental patient outcomes. The administration of prophylactic antibiotics is essential for preventing surgical site infections, with the timing of administration being crucial for achieving sufficient tissue concentrations at the moment of surgical incision. Conventional guidelines advocate for the administration of antibiotics 30–60 minutes before incision.

Objective:

To assess the effect of shortened pre-incision antibiotic infusion duration on the occurrence of surgical site infections.

Methods:

A prospective observational study was performed over 9 months, involving 115 individuals receiving elective surgical procedures. Patients were classified into two groups according to the timing of antibiotic administration: conventional timing (30–60 minutes before surgery) and reduced timing (less than 30 minutes prior to incision). The principal outcome assessed was the occurrence of surgical site infections (SSIs). Statistical analysis was used to ascertain the significance of differences among groups, with a p-value of less than 0.05 deemed statistically significant.

Results:

A total of 115 patients were included, with comparable baseline characteristics between groups. The mean age was 45 years in the standard timing group and 43 years in the reduced timing group, while males constituted 60% and 58%, respectively. Patients receiving antibiotics within 30 minutes before incision demonstrated a significantly lower SSI rate (10%) compared to the standard timing group (18%) (p = 0.03).

Conclusion:

Minimised pre-incision antibiotic administration seems to be a secure and efficacious approach for decreasing SSI rates. Integrating this methodology into standard surgical protocols may enhance patient outcomes and diminish the incidence of postoperative infections.

Recommendations:

Surgical teams should consider administering prophylactic antibiotics within 30 minutes prior to incision to optimise tissue antibiotic concentration and reduce postoperative surgical site infections.

References

Steinberg JP, Braun BI, Hellinger WC, Kusek L, Bozikis MR, Bush AJ, et al. Timing of Antimicrobial Prophylaxis and the Risk of Surgical Site Infections. Ann Surg. 2009;250(1):1–7. https://doi.org/10.1097/SLA.0b013e3181ad5fca

Barkha NSSSSM, Chauhan MMM, Shoaib SMB, Elahi AF. Surgical Site Infection Rates : A Retrospective Study on the Effectiveness of Prophylactic Antibiotic Protocols. Int J Med Sci Clin Res Rev. 2024;7(01):149–57.

Jonge SW De, Gans SL, Atema JJ, Solomkin JS, Dellinger PE, Boermeester MA. Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection. Med. 2017;96(29):1–12. https://doi.org/10.1097/MD.0000000000006903

Popat AV, Ramani JK, Sindhal M. Impact of Shortened Preincision Antibiotic Infusion Time on Surgical Site Infection Rates : A Retrospective Cohort Study. Int J Pharm Clin Res. 2024;16(7):1577–80.

Kumar S, Kumari K, Kumar A, Paswan J. Effect of Shortened Pre-Incision Antibiotic Infusion Time on Surgical Site Infections : A Retrospective Cohort Study. Int J Curr Pharm Rev Res. 2025;17(8):195–9.

Kishore P, Kumar M, Alam K. Impact of Reduced Preincision Antibiotic Infusion Time on Surgical Site Infection Rates : A Retrospective Cohort Study. Int J Curr Pharm Rev Res. 2025;17(4):1506–10.

Tomar S, Dhakarey SS, Resident S, Prophylaxis PA, Resident S. A RETROSPECTIVE COHORT STUDY ON REDUCED PRE-INCISION ANTIBIOTIC INFUSION TIME: EFFECTS ON SURGICAL SITE INFECTION RATES. Student’s J Heal Res Africa. 2024;5(3):1–6.