Assessment of rational use of antibiotics in surgical prophylaxis and post- operative cases at district hospital Gulbarga

Zaheeruddin Ather; N. Lingaraju; Santosh Lakshman; S. S. Harsoor

doi:10.18203/2349-2902.isj20170038

Authors

Zaheeruddin Ather Department of Surgery, ESICMC, Gulbarga, Karnataka, India
N. Lingaraju Department of Surgery, MIMS Mandya, Karnataka, India
Santosh Lakshman Department of Surgery, ESICMC, Gulbarga, Karnataka, India
S. S. Harsoor Department of Surgery, ESICMC, Gulbarga, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20170038

Keywords:

Antibiotic prophylaxis, Nosocomial infections, Surgical site infections

Abstract

Background: Postoperative wound infections are the major cause of morbidity in surgical patients. The use of pre and peri-operative antibiotics, with sound and appropriate principles of prophylaxis are applied can result in a reduced risk of postoperative infection. Although the principles of antimicrobial prophylaxis for surgical procedures have been well defined for many years, inappropriate and excessive use of antimicrobials for this purpose remains widespread.

Methods: This was a prospective study conducted on the inpatients undergoing surgical procedures. ASHP (American Society of Health System Pharmacists) and SIGN (Scottish Intercollegiate Guidelines Network) guidelines were used as the standard guideline.

Results: Of the total 150 procedures reviewed, 130 procedures were entered in the analysis. Of these procedures, the rate of totally compliant prescriptions was 28.46%. Totally in 93 (71.53%) patients, the antibiotic prophylaxis was found to be inappropriate. In 36 (27.70%) patients, indication for antibiotic prophylaxis was not proper and in total 38 (44.19%) patients, where antibiotic prophylaxis was justified and given, proper antimicrobial agent was not used.

Conclusions: Instead of existence of the written guidelines for antimicrobial surgical prophylaxis there are significant deviations from the recommendations in current clinical practice. Adherence of antibiotic prophylaxis to these guidelines is needed to be evaluated routinely in clinical practice.

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References

Ahmed AH, Rabindra SB. ASI Text Book of Surgery. Tata McGraw- Hill, 2003.

Aragon VP, Garcia LM, Sanchez CP, Canovas MT, Olmo GD. Nosocomial infection and related risk factors in a general surgery service: a prospective study. J Infection. 2003;46:17-22.

Dale BW, Peter HM. Antimicrobial prophylaxis for surgery: An advisory statement from the national surgical infection prevention project. Clinical Infectious Dis. 2004;38:1706-15.

Yalcin AN, Serin S, Erbay H, Tomatir E, Oner O, Turgut H. Increased costs due to inappropriate surgical antibiotic prophylaxis in a university hospital. J Hosp Infect. 2002;52(3):228-29.

Gottrup F. Prevention of surgical wound infections. New England J Med. 2000;342(3):202-4.

Eric HT, Dick GR. Text book of therapeutics: drugs and disease management. 6th edition. Baltimore: Williams and Wilkins. 1996.

Smith J, Finn A. Antimicrobial prophylaxis. Arch Dis Child. 1999;80:388-92.

Scottish Intercollegiate Guidelines Network. Antibiotic prophylaxis in surgery: a National Clinical Guideline. Edinburgh, UK: Sign Publication. 2000.

Ferguson J. Antibiotic prescribing: How can emergence of antibiotic resistance be delayed? Australian Prescriber. 2004;27(2):39-42.

Suggested Recommendations and Guidelines for Surgical Prophylaxis. Available at http://www.intmed.mcw.edu/drug/surgproph.html. Assessed on 2nd May 2005.

Silver A, Eichorn A, Kral J, Pickett G, Barie P, Pryor V, et al. Timeliness and use of antibiotic prophylaxis in selected inpatient surgical procedures. Am J Surg. 1996;171:548-52.

Harlan SH, Bonnie HB, Laura KD, Geheber CF, Ann HC. Prophylactic and preventive antibiotic therapy: timing, duration and economics. Ann Surg. 1979;189(6):691-9.

David CC, Scott ER, Pestonik EL, Horn SD, Menlove RL, Burke JP. The timing of prophylactic administration of antibiotics and the risk of surgical wound infection. New England J Med. 1992;326(5):281-6.

Aparecida M, Prado MB, Patelli M, Lima JS, Rocha IJ, Gomes H. The implementation of a surgical antibiotic prophylaxis program: the pivotal contribution of the hospital pharmacy. Am J Infection Control. 2002;30(1):49-56.