A Prospective Comparison of Ceftriaxone and Levofloxacin for Surgical Site Infection Prophylaxis in Elective General Surgeries

Background: Surgical Site Infections (SSIs) are prevalent postoperative complications that can lead to increased morbidity, prolonged hospital stays, and elevated healthcare costs. Prophylactic antibiotic administration is a standard practice aimed at reducing the incidence of SSIs. This study compares the efficacy of ceftriaxone and levofloxacin as prophylactic antibiotics in patients undergoing elective general surgeries. Methods: A prospective, comparative study was conducted involving 100 patients scheduled for elective general surgeries. Participants were randomized into two groups: Group A received a single preoperative dose of ceftriaxone (1g IV), and Group B received levofloxacin (750mg IV). Data collected included patient demographics, type of surgery, incidence and grading of SSIs (using the Southampton grading system), microbiological profiles of infections, duration of hospital stay, and total antibiotic dosage administered. Results: The overall incidence of SSIs was 39%, with 22 cases in the ceftriaxone group and 17 in the levofloxacin group (p = 0.78). The most common procedures associated with SSIs were hernioplasty and cholecystectomy. Predominant pathogens isolated included Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Patients in the levofloxacin group had a shorter mean hospital stay, with 48% discharged within three days, compared to 8% in the ceftriaxone group. Additionally, 76% of patients in the levofloxacin group required ≤4 mg of antibiotics, whereas 78% in the ceftriaxone group required 4–10 mg. Conclusion: Both ceftriaxone and levofloxacin are effective as prophylactic antibiotics in elective general surgeries. However, levofloxacin demonstrated advantages in terms of shorter hospital stays and lower total antibiotic consumption. These findings suggest that levofloxacin may be a more cost-effective option for SSI prophylaxis in elective general surgical procedures.