WP1.9 - An audit of prophylactic antibiotic use in elective inguinal hernia repair

Abstract Aims National guidance states that antibiotic prophylaxis is not indicated in low-risk patients undergoing inguinal hernia repairs and that high-risk patients require a single dose. This audit aimed to compare the use of prophylactic antibiotics by general surgeons in a district general hospital performing elective inguinal hernia repair, to the current national guidance. The rate of post-operative wound infection was also recorded. Method All patients who underwent an elective inguinal hernia repair in the six months between January and June 2023, were identified retrospectively via the hospital database. Data was collected via the electronic patient record system on whether patients were prescribed antibiotics prophylactically at the time of surgery. Data was also collected on patient demographics including sex, age, BMI and rate of post-operative wound infection. Results The patient cohort was 94% male with an average age of 64. 94.79% of repairs were open. 53.33% of patients received antibiotics in line with national guidelines. Overall, 50.00% of patients in this audit had prophylactic antibiotics. The rate of post-operative wound infection was 1.04%, with 0% in patients who received prophylactic antibiotics and 2.08% in those who did not, which is not a statistically significant difference (P = 0.175). Conclusions Current evidence for antibiotic use is weak and therefore auditing local practice is essential in antibiotic stewardship. This audit is limited by the reliance on accurate record keeping, with regards to antibiotic prescribing and documentation of post-operative wound infections. Furthermore, patients may have had post-operative wound infections managed in the community setting.