Effectiveness of prophylactic single-dose IV antibiotic versus postoperative multi-dose oral antibiotic regimen for preventing surgical site infections: A prospective comparative study.

Objective: Surgical site infections (SSIs) are among the most common postoperative complications, contributing to morbidity, prolonged hospital stays, and healthcare costs. Prophylactic antibiotics are widely used, but the optimal regimen for clean elective surgeries remains debated. Material and Methods: A hospital-based analytical cross-sectional study was conducted over a six-month period (March-August 2025) in the department of general surgery of a tertiary-care teaching hospital. Ninety-four consecutive patients undergoing clean elective surgeries were enrolled and allocated to two groups: Group A (n=52) received a single intravenous (IV) dose of cefotaxime 30 minutes prior to incision, and Group B (n=42) received postoperative multidose oral antibiotics according to institutional protocol. Baseline demographic and clinical data were recorded, and patients were monitored for signs of SSI, including fever, tachycardia, redness, and wound discharge. Results: The mean age of Group A participants was 28.3±5.9 years compared to 36.4±7.3 years in Group B (p=0.042), though other socio-demographic variables were comparable. The overall incidence of SSI signs was low in both groups. Fever occurred in 13.4% of Group A and 14.2% of Group B; tachycardia occurred in 9.6% and 7.1%; redness in 1.9% and 7.1%; and wound discharge in 3.8% and 2.3% in Groups A and B, respectively; none of these differences were statistically significant (p>0.05 for all). Conclusion: Single-dose IV prophylaxis was as effective as postoperative multi-dose oral antibiotics in preventing SSIs in clean elective surgeries. Short-course prophylaxis is sufficient in this setting and supports rational antibiotic stewardship.