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Abstract - Pattern of Surgical antibiotic prophylaxis for surgical site infections in most common surgical procedures at two teaching hospitals, Islamabad, Pakistan
Zakir Khan, Naveed Ahmed, Faiz Ullah Khan, Asim ur-Rehman, Hazir Rahman

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

Zakir Khan1,2, Naveed Ahmed1, Asim-ur-Rehman1, Faiz Ullah Khan3,4, Hazir Rahman5

1Department of Pharmacy Quaid-i-Azam University Islamabad, Pakistan

2Institute of Health Sciences, Department of Pharmacology (Pharmacovigilance), Çukurova University, Adana, Turkey

3Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Health Science Centre, Xi'an Jiaotong University, China

4Department of Pharmacy Quaid-i-Azam University Islamabad, Pakistan

5Department of Microbiology, Faculty of Chemical and Life Sciences, Abdul Wali Khan University, Mardan, Pakistan

 

ABSTRACT

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.

 

Volume 09, Number 03 (2019)