Analysing the Effect of Prophylaxis Antibiotic Administration on Pediatric Clean Surgery Based on Post Operative Response of Neutrophil, Monocyte, and Lymphocyte, and Surgical Site Infection Rate

Abstract

Insignificant administration of antibiotic leads to higher health cost and increase of antibiotic resistance. National prophylaxis antibiotic guideline on clean surgery amongst developed countries are varies meanwhile most developing countries still do not have any and adopt the established guidelines, not to mention there is not many specific guidelines for pediatric procedure. In Indonesia, 30% to 80% antibiotic usage was proven unnecessary.

This study analysed the effect prophylaxis antibiotic administration on pediatric clean surgery based on post operative response of neutrophil, monocyte, and lymphocyte, as the parameters of cell-mediated inflammatory response on tissue injury or infection, and surgical site infection rate.

A double blind randomized clinical trial was conducted from May 2013 to April 2014 at multi-hospital in Medan, Indonesia. Total sample is 42 subjects, distributed evenly into 2 groups. Post operative blood sample was examined on 3rd day and surgical wound was evaluated until 30th day.

Both groups were comparable in patients’ demographic, clinical characteristic, and surgery procedure. Post operative rates of neutrophil, monocyte, and lymphocyte are not statistically different between groups (P = 0.083, P = 0.121, dan P = 0.486). Pre and post operative difference rates of neutrophil, monocyte, and lymphocyte are not statistically different between groups (P = 0.065, P = 0.294, dan P = 0.367). Surgical wound complication was 2.4% of total 42 sample (P = 1,00) with 0% surgical site infection event on both groups. This study recommends prophylaxis antibiotic administration on pediatric clean surgery is not necessary.