Inappropriate surgical chemoprophylaxis and surgical site infection rate at a tertiary care teaching hospital

Rana, Devang; Malhotra, Supriya; Patel, Varsha J.

doi:10.1016/j.bjid.2012.09.003

Cited by 10 publications

(14 citation statements)

References 17 publications

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“…However, in current study, out of 103 patients for whom AMP administered, 73(70.6%) patients took Ceftriaxone alone or in combination with Metronidazole 25(24.3%). The result was in agreement with previous studies (Gandage et al, 2013;Rana et al, 2013;Afzal Khan et al, 2013). In contrast to this, Cefazoline was most frequently administered medication in similar studies (Vessal et al, 2011;Rafati et al, 2014;Parviz et al, 2013).…”

Section: Discussionsupporting

confidence: 94%

Evaluation of surgical antimicrobial prophylaxis use in Ethiopia: Prospective study

Legesse¹,

Hiko²,

Ismael³

et al. 2018

Afr. J. Pharm. Pharmacol.

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Appropriate use of surgical antimicrobial prophylaxis can prevent approximately 40 to 60% of surgical site infections. Inappropriate use is associated with emergency of antimicrobial resistance, occurrence of side effects and increased health care cost. We aimed to evaluate surgical antimicrobial prophylaxis use of Hawassa University Referral Hospital against standard guideline Prospective observational study was done on 105 patients who undergone major surgical procedure between March 2 and May 2, 2015. Data was collected from patient medication charts, operational and anesthesia notes, by direct observation and patients' interview using pre-tested questionnaire. All patients were followed daily before, during and after operation till discharge. We coded and cleaned the data using Epi-Data version 3.1 and exported to SPSS for window version 20.0 software for analysis. Overall adherence to American society of health-system pharmacists (ASHP) for surgical antimicrobial prophylaxis use guideline was not observed for all parameters evaluated. Surgical antimicrobial prophylaxis was indicated only in 85(80.9%) patients but administered in 103 (98.1%) patients. Choice of antimicrobial was discordant for all patients for whom antimicrobial prophylaxis was indicated and administered. Ceftriaxone was the most frequently administered 73(70.9%) antibiotics followed by combination of Ceftriaxone and Metronidazole 25(24.3%). Among 98.1% of patients who took antimicrobial prophylaxis , time of first dose administration and duration of administration were concordant in 38(36.9%) and 19(19.1%), respectively. Overall adherence to ASHP guideline was far from optimal for all parameters evaluated.

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Section: Discussionsupporting

confidence: 94%

Evaluation of surgical antimicrobial prophylaxis use in Ethiopia: Prospective study

Legesse¹,

Hiko²,

Ismael³

et al. 2018

Afr. J. Pharm. Pharmacol.

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“…Patients who develop SSIs are up to 60% more likely to spend time in an intensive care unit, 5 times more likely to be readmitted to hospital, and 2 times more likely to die compared with patients without SSIs [7, 12–14]. It account for 3.7 million excess hospital stay days, more than $1.6 billion excess costs annually and 3.57 extra drug use [4, 13, 15–18]. …”

Section: Introductionmentioning

confidence: 99%

Incidence and predictors of surgical site infection in Ethiopia: prospective cohort

2017

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BackgroundSurgical site infections are commonest nosocomial infections and responsible for considerable morbidity and mortality as well as increased hospitalizations and treatment cost related to surgical operations. The aim of this study was to determine incidence and predictors of surgical site infections at surgical ward of Hawassa University Referral Hospital, Southern Ethiopia.MethodsWe performed prospective study involving 105 patients that undergone major surgical procedure at Hawassa University Referral Hospital from March 2 to May 2, 2015. Data were extracted from paper based medical charts, operational and anesthesia note, by direct observation and patients’ interview. All patients were followed daily before, during and after operation for 30 days starting from the date of operation. Data were analyzed using Statistical Package for Social Science (SPSS) for window version 20.0 software. Predictors of Surgical site infections were identified using multivariable logistic regression model. P-value less than 0.05 was considered to be statistically significant.ResultWe studied 105 patients. Sixty four patients (61%) were males. The mean age of the patients was 30.85 ± 17.72 years. The mean Body Mass Index (BMI) was 21.6 ± 4 kg/m2. Twenty patients (19.1%) developed surgical site infections. Age greater than 40 years, AOR = 7.7(95% CI [1.610–40.810 p = 0.016,]), preoperative hospital stay more than 7 days, AOR = 22.4(95% CI [4.544–110.780, p = 0.001]), duration of operation more than 1 hour, AOR = 8.01(95% CI [1.562–41.099, p = 0.013]) and administering antimicrobial prophylaxis before 1 hour of operation, AOR = 11.1 (95% CI [1.269–75.639, p = 0.014]) were independent predictors for surgical site infections.ConclusionSurgical site infection is relatively high.

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“…Appropriate prophylactic antibiotics administration before surgery can reduce the incidence of SSI. However, inappropriateness of antibiotic prophylaxis administration is still commonly found in various surgical procedures, including orthopedic surgery [3][4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

“…However, adherence to the guidelines in choosing the type and timing of antibiotic prophylaxis administration is not always followed [1,5,6,[10][11][12][13] . This situation has led to high incidence of antibiotic resistance worldwide, which has a significant impact on public health issues, especially on treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of antibiotic prophylaxis administration at the orthopedic surgery clinic of tertiary hospital in Jakarta, Indonesia

Radji

Aini

Fauziyah³

2014

Asian Pacific Journal of Tropical Disease

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Inappropriate surgical chemoprophylaxis and surgical site infection rate at a tertiary care teaching hospital

Abstract: Inappropriate use of antimicrobials is highly prevalent in surgical chemoprophylaxis leading to higher surgical site infection rate. Adoption of international standard and formulation of locally feasible guidelines can help overcome this situation.

Cited by 10 publications

References 17 publications

Evaluation of surgical antimicrobial prophylaxis use in Ethiopia: Prospective study

Evaluation of surgical antimicrobial prophylaxis use in Ethiopia: Prospective study

Incidence and predictors of surgical site infection in Ethiopia: prospective cohort

Evaluation of antibiotic prophylaxis administration at the orthopedic surgery clinic of tertiary hospital in Jakarta, Indonesia

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