Prospective Monitoring of Antibiotic Reactions in Outpatient Hand Surgery
Kristin Sandrowski, MD; David Edelman, MS; Lauren Banner, MS; Michael Rivlin, MD; Christopher Jones, MD; Mark Wang, MD; Pedro K Beredjiklian, MD
Thomas Jefferson University Hospital, Philadelphia, PA
Administration of antibiotic prophylaxis prior to surgery has been routine practice to decrease the risk of postoperative wound infections. Subsequently studies have debated the benefit of antibiotic prophylaxis in elective orthopedic surgery compared to the potential risks including rash, diarrhea or more serious reactions. To our knowledge no study has prospectively followed patients to monitor for adverse reactions and complications following routine administration of antibiotics at the time of surgery.
Materials and Methods: All patients undergoing outpatient upper extremity surgery by five surgeons were prospectively followed between April and June of 2017. Patients were monitor while at the surgical center, contacted by phone and evaluated at their two-week post operative visit to monitor for adverse reaction related to antibiotic administration. Patients were excluded if they were on antibiotics prior to surgery, if they did not receive antibiotics at the time of surgery or if they wished to be excluded form the study.
Results: 411 Patients were identified, 4 were excluded due to antibiotic treatment leading up to surgery and 5 requested not to participate. Of the remaining 402 patients, only 7 (1.74%) reported adverse reactions related to antibiotic administration. Four patients reported a rash; two patients developed the rash during the administration of antibiotics.
Two Patients reported diarrhea (0.5%) and one patient reported a yeast infection (0.2%). The patient who developed a yeast infection was discharged on a short course of antibiotics in addition to their preoperative dose. A total of 58 patients were discharged on a short course of oral antibiotics by one surgeon as part of his routine practice (14.4%).
Despite discussion in the literature regarding the risks of preoperative antibiotic administration, our study found a low rate of adverse reactions with no serious complications.
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