Comparison of ceftriaxone and cefuroxime for surgical prophylaxis in othopaedic practice

ABSTRACT

Aims: To assess the effect of a single dose of Ceftriaxone as compared to three doses Cefuroxime and its economic implications. Prospectively 60 consecutive patients [Group A] undergoing Orthopaedic surgery, were given a single dose of Ceftriaxone 1 gram intravenously, prophylactically 30 minutes preoperatively. In comparison the control group of 60 patients received Cefuroxime 1.5 gram preoperatively and 2 doses of 750 mg postoperatively [Group B]. The duration of the operation and they type of operation was recorded. Post operatively the patients were followed up for a year to find any infection related to the surgery. There were 17 males in Group A and 21 in Group B and the rest were females. The average age in the study group was 34.65 years [range 14-66 years] and in the control group the mean age was 35.5 year [range 16-80 years]. The duration of surgery was 112.2 minutes [35-210 minutes] in Group A and 108.5 minutes [40-200 minutes] in Group B, respectively. In the ceftriaxone group there was no postoperative wound infection as compared to the cefuroxime group in which three patient had infection [5%] which was clinically significant and the pValue was 0.24. One superficial and 2 deep infection. this study indicates that a single dose of 1 gram of ceftriaxone was more effective and economically better than the 3 doses of cefuroxime for prophlaxis in orthopaedic surgery. Moreover in the present climate of stringent hospital budgets, using ceftriaxone will save nursing time and cost per patient for prophylaxis in othopaedic surgery