Clindamycin is superior to cefazolin prophylactic regimen in a general trauma reference hospital - a comparative retrospective study

Abstract

Abstract Background: Surgical site infections (SSI) are among the most common adverse events in the hospital setting. clindamycin is an option to the use of cefazolin, already recommended in the literature although few studies evaluate its effectiveness. due to the increase in cost, since October 2019, cefazolin has been replaced by clindamycin in our hospital. This study aimed to analyze the impact of using clindamycin compared to cefazolin in the prophylaxis of SSI. Methods: The authors executed a cross-sectional study of patients submitted to surgical procedures with antimicrobial prophylaxis between October 2018 and October 2021. The primary outcome was surgical site infection. Data from medical records included gender, age, type of surgery, surgical specialty, surgery wound, bacteria isolated, surgical complications, hospital readmission, and death. A comparison between means was made by the t-student test. For dichotomous variables, the chi-square was performed. Results: 12,238 surgical procedures were included, 6,776 with clindamycin and 5,462 with cefazolin. There was no difference in surgical wound classification in both groups. The SSI rate in the group cefazolin was 1.9% (n=104) and 1.2% (n=85) in the group clindamycin [OR 1.65, CI95% 1.19 – 2.15, (p<0.001)]. Staphylococcus aureus was the most common pathogen. Gram-positive cocci were 60% in the group cefazolin and 57% in the group clindamycin. distribution of MRSA was similar between both groups. Conclusion: Our results demonstrated a lower SSI rate with clindamycin. Despite the retrospective design, we may conclude that clindamycin is a feasible option for cefazolin.