ANTIBIOTIC PROPHYLAXIS IN SURGICAL SITE INFECTION PREVENTION: A PROSPECTIVE OBSERVATIONAL STUDY OF CLEAN AND CLEAN-CONTAMINATED CASES

Background: Surgical Site Infections (SSIs) remain a major cause of postoperative morbidity, especially in clean and clean-contaminated surgeries. Optimal antibiotic prophylaxis is essential to prevent SSIs and reduce hospital burden. Objective: To compare the effectiveness of preoperative prophylactic antibiotics versus postoperative therapeutic antibiotics in preventing SSIs and to evaluate the influence of risk factors, timing, and antibiotic choice. Methods: A prospective observational study was conducted for six months in the Department of General Surgery, Malla Reddy Hospital. A total of 250 patients were allocated into two equal groups based on antibiotic strategy. • Group A: Received a single dose of IV pre-operative Antibiotic (ceftriaxone) 30–60 minutes before surgical incision. • Group B: Received only postoperative antibiotic therapy (cefotaxime/ceftriaxone/ fluroquinolones) for 2–3 days without pre-operative prophylaxis. Demographics, comorbidities, surgery type, antibiotic timing, and SSI occurrence were assessed. Statistical tests included Chi-square, ANOVA, and logistic regression. Results: Group A demonstrated a significantly lower SSI rate (23.2%) compared to Group B (48.8%) (p < 0.05). Clean-contaminated surgeries and comorbidities (DM, HTN) were associated with higher SSI risk. Optimal timing (≤30 min) and IV route were strongly protective. Conclusion: Preoperative IV ceftriaxone given within 30 - 60 minutes before surgical incision is markedly more effective than postoperative therapeutic antibiotics in preventing SSIs. Adherence to prophylaxis timing and antibiotic stewardship is essential to improve surgical outcomes.