Pattern of Surgical Antibiotic Prophylaxis for Surgical Site Infections in at two Teaching Hospitals, Islamabad, Pakistan

Year 2019, Volume: 09 Issue: 03, 104 - 111, 15.09.2019

Zakir Khan Naveed Ahmed Asim-ur- Rehman Faiz Ullah Khan Hazir Rahman

https://doi.org/10.5799/jmid.614180

Cited By: 4

Abstract

Objectives: To investigate the utilization pattern of Surgical
antibiotic prophylaxis (SAP) for the prevention of surgical infections in most
common abdominal and orthopedic surgical procedures.

Methods:
A prospective observational and non-intervention study was conducted at two
teaching hospitals (PIMS and SIH) in Islamabad, Pakistan. Prescriptions records
were reviewed to assess the utilization pattern of SAP during the nine-month duration.
Data regarding most common surgical procedures, antimicrobial utilization,
dose, route and administration timing of SAP were extracted for analysis.
Observed practices were compared with standard treatment guidelines.

Results:
Out of total 1512 surgical procedures about, 56.9% (n=860) of patients
performed abdominal followed by 652 (43.1%) orthopedic surgical procedures. A
total of 212 (14%) surgical procedures were completely correct in all steps.
SAP were given in 1474 (97.5%) of surgical procedures. In 712 of the
participants (48.3%) were given Ceftriaxone following by Cefazolin (n=247,
16.7%). Abdominal surgeries were majorly managed with Ceftriaxone (59%) while
the orthopedic surgeries managed with Ceftriaxone (31.3%) and Cefazolin (30%).
Appropriate choice of SAP was observed in (n=275; 18.6%) procedures and about
half (n=719, 49%) received antibiotics within optimal timing. The appropriate
choice/selection of SAP according to the guidelines was greater in orthopedic
surgical procedures (n=212; 14.8%) than abdominal surgeries (n=63; 4.3%); p≤0.001.
Compliance with respect to timing was significantly lower in an orthopedic
surgical procedure (n=301) as compared to abdominal surgeries (n=418); p≤0.001.
Similarly, a statistically significant difference observed between PIMS and SIH
with respect to SAP practices; p≤0.001.

Conclusions: Inappropriate choice, the timing of administration
and combination of SAP were observed in the current study. J Microbiol Infect Dis 2019; 9(3):104-111.

Keywords

Surgery, perioperative, antibiotic, prophylaxis, hospital

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