Abstract

A PROSPECTIVE SINGLE BLINDED STUDY TO ASSESS THE SAFETY AND EFFICACY OF CARBAPENEMS FOLLOWING POST OPERATIVE CARE IN PATIENTS WITH PRIMARY INFECTIONS

Mohammed Sulaiman Sait J.*, Shanmugarajan T. S. and Shanmugasundaram P.

ABSTRACT

Introduction: Post operative wound management remains a major challenge in post operative care. Delayed healing because of surgical site infection could extend the patient stay at the hospital. There are various antimicrobial agents used in post operative care. Carbapenems are extended spectrum Beta-Lactams which could provide better wound management in post operative care in patients with primary infections. Objective: The main objective of this study is to compare the safety and efficacy of patients on carbapenem (Ertrapenam, Imipenem and Doripenem) following post operative care. Methodology: This study was a single blinded study done at a hospital in Chennai after obtaining clearance from the Institutional ethics committee. Surgeons initiated the patients on carbapenems based on randomization in patients based on inclusion and exclusion criteria whereas the investigators remained blinded. Various study parameters such as wound size, nature, condition, closure, pus culture, along with renal parameters and Adverse Drug Reactions were monitored. Drug un-blinding was done and statistical analysis was done. Results: A total of 78 patients were included in the study. The most commonly used carbapenem was Ertapenem (42.30%) that showed a wound healing of about 74%, where as Dorepenem showed 72% and Imepenem showed 69%.Overall wound healing was seen in 73 patients (93.5%) patients whereas 5 patients (6.49%) had infected wound sites whose stay at the hospital increased by an average of 5.6 days. The most common organism isolated from wound site was Methicillin sensitive Staphylococcus (60%). No significant Blood Urea Nitrogen and Serum creatinine changes were seen. Conclusion: Carbapenems are safe to be used in post operative care in reducing the risk of surgical site infections in patients with primary infections. Ertapenem has an advantage of being once daily dose and slightly better wound healing whereas; Dorepenem has a better safety profile and Imepenem had less renal stress.

Keywords: Surgical Wound Infection, Carbapenems, Ertapenem, Imipenem, Doripenem.