Comparison of the Preventive Efficacy of Topical and Injectable Meropenem versus Cefotaxime in Preventing Wound Infection in Umbilical Hernia Repair

Background and Objective: Wound infection remains a troublesome problem that may complicate any surgical procedure. Prophylactic antibiotics are an important measure in reducing the rate of wound infection. The aim of this study was to evaluate and compare the efficacy of two different antibiotics (meropenem and cefotaxime) and different administration methods in preventing wound infection after umbilical hernia repair. Methods: This cross-sectional study was conducted on 321 patients who underwent umbilical hernia repair by primary closure or mesh repair. A prophylactic antibiotic was used in all patients. They were divided into three groups depending on the type of antibiotic used and the method of administration. Group I received a single intravenous dose of cefotaxime before the procedure. Group II received one dose of intravenous cefotaxime preoperatively and another dose of cefotaxime injected locally at the operative site, and Group III received one dose of intravenous meropenem preoperatively plus another dose of local injection. All patients were monitored for evidence of wound infection for 30 days. Findings: Of the 321 patients studied, 243 were female and 78 were male. The overall wound infection rate was 7.7%. Group III (meropenem used) had the lowest wound infection rate (0.9%) and was significantly different from the other groups (15% in Group I and 7.5% in Group II) (p<0.05). Also, the length of stay in Group III (2.2 days) was shorter than Group II (1.5 days) and Group III (one day). Conclusion: The results of the study showed that topical and systemic administration of antibiotics effectively reduces the risk of wound infection. However, combined topical and systemic administration of meropenem provides the best result in controlling wound infection.