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Current status of post-operative antibiotic prophylaxis in surgical wards

Tejas Khakhkhar, Rima Shah, K. G. Hemavathi.




Abstract

Background: Appropriate antibiotic prophylaxis can reduce the risk of post-operative wound infections, but misuse and overuse of antibiotics increase cost and emergence of resistant bacteria. Despite the existence of general recommendations for antibiotic prophylaxis, many deviations from these recommendations are still reported notably for antibiotic choice and duration of prophylactic administration.

Objective: This study was conducted to evaluate the pattern of post-operative prophylactic antibiotics in surgical wards at Dhiraj Hospital, a tertiary care teaching hospital attached with SBKS Medical Institute and Research Center, Piparia, Vadodara, Gujarat, India.

Materials and Methods: In this prospective observational study, a total of 200 patients from various surgical wards were included. Pretested pro forma which included information on choice of antimicrobial agents as well as their route, number and total duration of prophylaxis were completed. Furthermore, appropriateness of antibiotic prophylaxis was assessed as per standard guidelines.

Results: All the patients received post-operative antibiotic doses. The majority of patients (98, 49%) were prescribed three antibiotics. Most of the post-operative use of antibiotics was not as per standard guidelines in terms of choice of antibiotics and total duration of treatment. The patients received post-operative antibiotics for a mean duration of 9.84 days during their hospital stay.

Conclusion: In spite of existence of the written guidelines for antimicrobial surgical prophylaxis, there are significant deviations from the recommendations in current clinical practice. To promote the rational use of antibiotics in surgical prophylaxis, implementation of and adherence to evidence-based guidelines and recommendations for antimicrobial surgical prophylaxis is strictly required.

Key words: Antibiotic Prophylaxis; Post-operative; Evidence-based Guidelines






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