Use of antibiotics in surgical setup in tertiary healthcare hospital

Abstract

Surgical antimicrobial prophylaxis refers to brief course of an antimicrobial agent which is initiated just before surgery, to prevent any infections at the surgical site. It is one of the most widely accepted practices in surgery. However, despite the evidence of the effectiveness and the publication of guidelines for the antimicrobial prophylaxis, its use is often found to be suboptimal. However, between 30-90% of this prophylaxis is inappropriate.Hence, this study was planned in order to examine the prevalent practices in the tertiary care hospital regarding the use of antimicrobials for surgical prophylaxis, with respect to the choice of the antimicrobial agent, the timing of its administration, the intraoperative reposing and the total duration of the prophylaxis, in order to detect any inappropriateness, so that corrective measures could be suggested.A survey was conducted across the various departments undergoing surgery of 213 patients and was followed till their discharge. The age of patients varied from 5 to 85 years. Following risk factors were also included like anemia, smoking, alcohol, prolonged duration of surgery. All the cases in our study received prophylactic antimicrobials prior to surgery, even though prophylactic systemic antimicrobials are not typically indicated for the patients who underwent clean surgical site operations.Though, this aspect was also the basis of forming two groups viz. group A and group B; this mode of treatment prior to surgery was found effective. Males are more prone to treatment failure, as suggested by the study. While recovery in females with the preliminary line of treatment continues in a positive way. A 75 cases out of 213 undergoing surgeries which are given planned regimes of antibiotic prophylaxis still end up with surgical site infection which is many a times not notified. To overcome this, change in antimicrobial regime is employed.