Post operative infection, pyrexia and perioperative antimicrobial drug use in surgical colic patients.

The research article investigates how post operative fever and the timing/duration of antibiotic treatment affect the likelihood of infection in patients undergoing surgery for colic. Also, it suggests careful consideration of antibiotic use for mild post-surgery fever.

Research Objectives

• The study aims to establish a correlation between post-operative fever and the onset of infection.
• It also investigates any link between the timing and duration of antibiotic usage around surgical procedures and infection rates in patients operated on for colic.

Research Methodology

• This was a retrospective study, with researchers reviewing medical records of patients who had undergone surgical treatment for colic.
• The study included only those patients who had a recovery period post-surgery of more than 48 hours.
• Data was collated on various aspects such as patient details, duration of surgery, incidence of post-operative infection, antibiotic usage, presence and severity of post-surgery fever, etc.
• Data analysis involved standard statistical methods for simple comparison and logistic regression for more complex relations.

Key Findings

• Of the 113 horses in the final analysis, 43% were diagnosed with post-operative infection.
• The duration of surgery and anesthesia was found to be associated with post-operative infection.
• 85% of the horses had post-operative fever, but the presence of fever was not necessarily indicative of ensuing infection. In fact, fever higher than 39.2°C, sustained for over 48 hours post-surgery, or delayed onset of peak temperature (more than 48 hours after surgery), were significantly associated with infection.
• A combined model showed that time to first post-surgery fever above 48 hours, peak temperature, and delay in peak time were equally indicative of post-operative infection; the predictive value of this model was 72%.
• The timing and dosage of preoperative antibiotics didn’t have an impact on infection rates but the duration of post-operative antibiotic usage did.

Conclusion

• Mild to moderate fever (38-39.4°C) in the early stages post-surgery in colic patients is not necessarily linked to potential bacterial infection.
• The study suggests that the use of antibiotics might be unnecessary and expensive in patients exhibiting mild post-operative fever, and may only be required for more prolonged or severe fevers.