Does routine prophylactic oral flucloxacillin reduce the incidence of post-circumcision infections?

Limakatso Lebina, Fatima Laher, Hillary Mukudu, Thandekile Essien, Kennedy Otwombe, Glenda Gray, Neil Martinson

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Cost-effective and safe practices are required for the scale-up of medical male circumcision (MMC), a strategy recommended for biomedical HIV prevention. Methods: A retrospective medical record review was conducted of post-circumcision wound infection incidence at a massive MMC program in Soweto, South Africa. We compared patients who received routine 250 mg prophylactic flucloxacillin 4 times daily orally for 5 days with those who did not receive prophylaxis. Patients with HIV infection and those with missing prophylaxis data were excluded from the analysis. Collated data included prophylaxis received, age, return for follow-up, and presence and grading of wound infection at follow-up. Results: In total, 1,291 patients were eligible: 646 flucloxacillin recipients and 645 non-recipients. Median age of flucloxacillin recipients was 24 years (interquartile range 20-29 years) and for nonrecipients it was 23 years (interquartile range 16-28 years). Eighty-one percent of flucloxacillin recipients and 87% of nonrecipients (P =.0019) returned for follow-up. Wound infection was present in 0.7% (5 of 646) of flucloxacillin recipients and 1.2% (8 of 645) of non-recipients (P =.4). Use of routine prophylactic flucloxacillin did not significantly reduce incidence of post-MMC wound infection (odds ratio, 0.6; 95% confidence interval, 0-1.2). Conclusions: When compared with no prophylactic flucloxacillin, routine prophylactic flucloxacillin does not significantly reduce the risk of post-MMC wound infection in a massive circumcision program.

Original languageEnglish (US)
Pages (from-to)897-900
Number of pages4
JournalAmerican Journal of Infection Control
Volume41
Issue number10
DOIs
StatePublished - Oct 2013
Externally publishedYes

Keywords

  • HIV
  • Infection prevention
  • Medical male circumcision
  • MMC program
  • Wound infections

ASJC Scopus subject areas

  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • Epidemiology
  • Health Policy

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