title: The effectiveness of i.v. cefuroxime prophylaxis of surgical site infection after elective inguinal hernia repair with mesh: A retrospective observational study.
abstract: OBJECTIVE
  The efficacy of routine antibiotic prophylaxis for prevention of surgical site infection (SSI) after elective inguinal hernia repair with a mesh patch remains uncertain. The authors of a recent Cochrane meta-analysis based on 17 randomized trials were unable to draw a definitive conclusion on this subject. The purpose of this study was to determine the effectiveness of prophylactic antibiotics for prevention of SSI after elective inguinal hernia repair with mesh and the risk factors for SSI.
  
  
  METHODS
  All low-risk patients who underwent elective inguinal hernia repair with mesh at our institution between 2010 and 2015 were enrolled in this study, with the exception of patients with recurrent hernias or immunosuppressive diseases. All patients received a single intravenous (i.v.) injection of cefuroxime (1.5 g) within 2 h prior to surgery at the discretion of the surgeon. SSI was defined using criteria of the Centers for Disease Control and Prevention. The variables which could influence the rate of SSI were analyzed by multivariate analysis to determine the independent risk factors for SSI.
  
  
  RESULTS
  Among the 605 patients who underwent elective inguinal hernia repair with mesh during the study period, 553 were eligible for enrolment in the study. Of these, 331 received a single dose of cefuroxime preoperatively. The overall SSI rate was 5.4 %; 9.4 % of those patients who did not receive preoperative antibiotic prophylaxis developed SSI versus 2.8 % of those who did receive prophylaxis (P = 0.001). All infections were superficial. Factors independently associated with SSI were advanced age, smoking and preoperative stay.
  
  
  CONCLUSIONS
  The incidence of SSI among low-risk patients who did and did not receive preoperative antibiotic prophylaxis after elective inguinal hernia repair with mesh differed significantly, particularly among patients of advanced age, smokers and patients with a prolonged preoperative stay in the hospital.
authors.affiliation: Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China. zhuoyeye_2005@126.com.
authors.forename: Yeye
authors.initials: Y
authors.lastname: Zhuo
authors.affiliation: Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
authors.forename: Danling
authors.initials: D
authors.lastname: Tang
authors.affiliation: Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
authors.forename: De
authors.initials: D
authors.lastname: Cai
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002444:Cefuroxime / Q000627:therapeutic use*; D017558:Elective Surgical Procedures; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002444:Cefuroxime
keywords: CDC criteria; Elective inguinal hernia repair with mesh; Preoperative antibiotic prophylaxis; Surgical site infection