Surgical antibiotic prophylaxis and compliance with the standard treatment guidelines in acute appendectomy at tertiary care teaching hospital
Abstract
Purpose: This study was conducted to investigate the rational use of surgical antibiotic prophylaxis (SAP) in acute appendectomy.
Materials and Methods: This research analyzed prospectively prescriptions of 400 patients who underwent acute appendectomy during six months study period at teaching hospital (Pakistan). Appropriates of SAP was evaluated according to American College of Surgeons and American Society of Health-System Pharmacists (ASHP) guidelines. The World Health Organization recommended Anatomical Therapeutic Chemical (ATC) methodology was also used for antibiotic utilization.
Result: Mean age of these patients was 28 years (IQR = 16-45; SD=8.5) years with majority of male patients (60%). Out of these, 37.3% adhered according to guidelines with respect to correct choice, 100% for dose, 100% for route and 49.5% for timing of antibiotic (optimal value 100%). The commonly and inappropriately prescribed antibiotic was ceftriaxone. Combination use of SAP was also reported.
Conclusion: Inappropriate choice, timing and misuse of
antibiotics are main reported problems in this study.
Kaynakça
- 1. Davidson GH, Flum DR, Talan DA, Kessler LG, Lavallee DC, Bizzell BJ, et al. Comparison of Outcomes of antibiotic Drugs and Appendectomy (CODA) trial: a protocol for the pragmatic randomised study of appendicitis treatment. BMJ open. 2017;7(11):e016117.2. Ferris M, Quan S, Kaplan BS, Molodecky N, Ball CG, Chernoff GW, et al. The global incidence of appendicitis: a systematic review of population-based studies. Annals of surgery. 2017;266(2):237-41.3. Ban KA, Minei JP, Laronga C, Harbrecht BG, Jensen EH, Fry DE, et al. American College of Surgeons and Surgical Infection Society: surgical site infection guidelines, 2016 update. Journal of the American College of Surgeons. 2017;224(1):59-74.4. Danwang C, Mazou TN, Tochie JN, Nzalie RNT, Bigna JJ. Global prevalence and incidence of surgical site infections after appendectomy: a systematic review and meta-analysis protocol. BMJ open. 2018;8(8):e020101.5. Garcell HG, Arias AV, Sandoval CAP, García EG, Gamboa MEV, Sado AB, et al. Incidence and etiology of surgical site infections in appendectomies: a 3-year prospective study. Oman medical journal. 2017;32(1):31.6. Alemkere G. Antibiotic usage in surgical prophylaxis: A prospective observational study in the surgical ward of Nekemte referral hospital. PloS one. 2018;13(9):e0203523.7. Nabor MIP, Buckley BS, Lapitan MCM. Compliance with international guidelines on antibiotic prophylaxis for elective surgeries at a tertiary-level hospital in the Philippines. Healthcare infection. 2015;20(4):145-51.8. Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surgical infections. 2013;14(1):73-156.9. Mahdaviazad H, Masoompour SM, Askarian M. Iranian surgeons’ compliance with the American Society of Health-System Pharmacists guidelines: Antibiotic prophylaxis in private versus teaching hospitals in Shiraz, Iran. Journal of infection and public health. 2011;4(5-6):253-9.10. Sviestina I, Mozgis D. Evaluation of the Antibiotic Use for Surgical Prophylaxis in Paediatric Acute Appendicitis. Journal of Young Pharmacists. 2015;7(1):7.11. Hansen S, Sohr D, Piening B, Pena Diaz L, Gropmann A, Leistner R, et al. Antibiotic usage in German hospitals: results of the second national prevalence study. Journal of Antimicrobial Chemotherapy. 2013;68(12):2934-9.12. Lin K-B, Lai KR, Yang N-P, Chan C-L, Liu Y-H, Pan R-H, et al. Epidemiology and socioeconomic features of appendicitis in Taiwan: a 12-year population-based study. World Journal of Emergency Surgery. 2015;10(1):42.13. Lee JH, Park YS, Choi JS. The epidemiology of appendicitis and appendectomy in South Korea: national registry data. Journal of epidemiology. 2010;20(2):97-105.14. Al-Omran M, Mamdani MM, McLeod R. Epidemiologic features of acute appendicitis in Ontario, Canada. Canadian journal of surgery. 2003;46(4):263.15. Askarian M, Moraweji AR, Mirkhani H, Namazi S, Weed H. Adherence to American Society of Health-System Pharmacists surgical antibiotic prophylaxis guidelines in Iran. Infection Control & Hospital Epidemiology. 2006;27(8):876-8.
