Utilization of surgical antibiotic prophylaxis for obstetrics and gynaecology surgeries in Northern Nigeria

Abubakar, Usman; Sulaiman, Syed Azhar Syed; Adesiyun, Adebiyi Gbadebo

doi:10.1007/s11096-018-0702-0

Cited by 46 publications

(70 citation statements)

References 38 publications

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“…However, all surgical antibiotic prophylaxis prescriptions in the current study were prolonged beyond 1 day. This implies that surgical antibiotic prophylaxis was overused, and confirmed the result of a previous study in Nigeria [12]. This observation highlights a potential target for antimicrobial stewardship intervention.…”

Section: Discussionsupporting

confidence: 85%

“…The objective of this study was to assess the prevalence of antibiotic use in secondary and tertiary acute care hospitals, and describe the indicators of quality antibiotic prescription including the documentation of reasons for antibiotic prescription and change of an initial antibiotic during current infection episode. Redundant antibiotics combination has been identified as a local problem in healthcare settings in the northern region [12]. The study also evaluated the prevalence, types and factors associated with redundant antibiotics combination in inpatient settings.…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Abubakar

2020

BMC Infect Dis

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Background: The evaluation of antibiotic use among hospitalized patients is a primary step required to design antibiotic stewardship intervention. There is paucity of data describing antibiotic use in hospitals across Northern Nigeria. This study evaluates the prevalence and indications for antibiotic use among inpatients in three acute care hospitals. Methods: A point-prevalence survey was conducted among patients in the wards before or at 8.00 a.m. on the day of the survey, using the point-prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals protocol. The survey was conducted between April and May 2019. The medical records of the patients were reviewed by a clinical pharmacist with the support of physicians and nurses.Results: Overall, 80.1% (257/321) of the patients used at least one antibiotic on the day of the survey. The prevalence of antibiotic use ranged from 72.9% in obstetrics and gynecology to 94.6% in pediatric medical specialty. Community acquired infections (38.7%) and surgical antibiotic prophylaxis (22.5%) were the most common indications. Surgical antibiotic prophylaxis was used or scheduled to be used for more than a day in all the cases. Metronidazole (30.5%), ciprofloxacin (17.1%), ceftriaxone (16.8%), amoxicillin-clavulanate (12.5%) and gentamicin (11.8%) were the most commonly prescribed antibiotics. Overall, broad spectrum antibiotics represented one-third of all the prescriptions. The change of initial antibiotic prescription was reported in one-third of the patients and the reasons include a switch to oral antibiotic (28.5%), escalation (4.5%) and de-escalation (3.6%). Of the 257 patients with an antibiotic prescription, 6.2% had redundant antibiotic combinations. Conclusion:The prevalence of antibiotic use was high with one in three prescriptions having a broad spectrum antibiotic. Prolonged use of surgical antibiotic prophylaxis and redundant antibiotic combination were observed. Antimicrobial stewardship interventions are recommended in order to reduce the use of antibiotics and promote appropriate antibiotics prescribing.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Abubakar

2020

BMC Infect Dis

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“…A similar finding was reported by an Australian study [21]. Low adherence rate was reported in Nigeria [20] and Egypt [27] with respect to the appropriate timing of administration. However, the higher adherence rate was reported in Jorden (99%) [22], England (86.4%) [28] and Palestine (76.6%) [29].…”

Section: Discussionsupporting

confidence: 86%

“…However, the higher adherence rate was reported in Jorden (99%) [22], England (86.4%) [28] and Palestine (76.6%) [29]. It is the best evidence that delayed administration of SAP is associated with 2-time greater risk of SSIs as compared to timely administration [20]. Appropriate time of administration of PPA can also reduce the duration of stay and hospitalization cost [3,4].…”

Section: Discussionmentioning

confidence: 99%

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

Khan

Ahmed²,

Rehman³

et al. 2019

Journal of Microbiology and Infectious Diseases

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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.

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“…Guidelines based on currently available clinical evidences are useful for the rational use of antibiotics to prevent the SSIs [10,[13][14][15][16]. Investigation of antibiotic prophylaxis is a crucial part of stewardship interventions [16].…”

Section: Introductionmentioning

confidence: 99%

Audit of pre-operative antibiotic prophylaxis usage in elective surgical procedures in two teaching hospitals, Islamabad, Pakistan: An observational cross-sectional study

et al. 2020

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An audit of the antibiotic prophylaxis in surgical procedures is the basic area of antimicrobial stewardship programme. The current research aimed to evaluate the adherence-proportion of the pre-operative antibiotic prophylaxis (PAP) practices in common elective surgical procedures. It was an eight-month (January 2017 to August 2017) observational cross-sectional patients' treatment record-based study conducted at two tertiary care teaching hospitals of Islamabad, Pakistan. We investigated the three most commonly performed elective general surgical procedures at the hospitals in adults aged > 18 years with no previous infection or surgery. The required data were extracted from the medical charts. Current prescribing practices were compared with the standard prescribing guidelines. A total of 660 (Government Hospital (GH), n = 330 and Private Hospital (PH), n = 330) procedures were observed. The most commonly performed elective general surgical procedures were laparoscopic cholecystectomy 307/660 (46.5%), followed by direct inguinal hernia 197/660 (29.8%) and total thyroidectomy 156/660 (23.6%). Non-use of PAP was observed in 64/660 (9.7%) cases. PAP was given to 90.3% (n = 596/660) cases (300/330 (90.9%) patients in GH and 296/330 (89.7%) in PH; P = 0.599). Based on the existing guidelines, the choice of antibiotics was correct in only 4.2% (25/596) patients (10/300; 3.3% cases at GH and 15/ 296; 5% at PH). The appropriate use of antibiotics was significantly greater in direct inguinal hernia (n = 19/193; 9.8%) cases compared with that in total thyroidectomy (n = 4/152; 2.6%) and laparoscopic cholecystectomy (n = 2/251; 0.8%) cases; P = 0.001. Compliance to the timing was only 51% (n = 304/596) of the total patients received PAP which was significantly lower in GH 97/300 (32.3%) as compared with that in PH 207/296 (69.9%); P = 0.001. Administration timing of antibiotics was observed to be more appropriate in total thyroidectomy (n = 79/152; 51.9%) cases than in laparoscopic cholecystectomy (n = 130/251; 51.8%) and direct inguinal hernia (n = 95/193; 49.2%) cases; P = 0.001. The route and dose were appropriate in accordance with the guidelines in all cases (100%). Most of the patients

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Utilization of surgical antibiotic prophylaxis for obstetrics and gynaecology surgeries in Northern Nigeria

Cited by 46 publications

References 38 publications

Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

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

Audit of pre-operative antibiotic prophylaxis usage in elective surgical procedures in two teaching hospitals, Islamabad, Pakistan: An observational cross-sectional study

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