Abstract
The main objective of the study was to assess the prescribing practice of antibiotic prophylaxis for differentsurgeries in hospitals of Pokhara valley. A descriptive, quantitative, retrospective study was used to evaluatethe patients who have undergone surgery between 15th April 2002 – 14th April 2003. A total of 950 patientswere taken from the medical record for the study. Data about patient (age, sex), surgery (type and indication),antibiotic/s prophylaxis (dose, duration) and length of hospital stay were collected. Caesarean Section (CS)was the common surgery in Western Regional Hospital (WRH) followed by cholecystectomy, 31.1% and24.4% respectively. In Manipal Teaching Hospital (MTH), dilatation and currettage (D and C, 21.6%) wasthe most common surgery followed by hysterectomy (21%). The mean length of stay in MTH for CS surgerywas 7.97 days whereas 7.01 days for WRH. Significant difference was found in length of stay of two hospitals(p<0.05). Antibiotic prophylaxis was given preoperatively in MTH (87%) and WRH (79.5%) respectively.Antibiotic prophylaxis was given intraoperatively in 1.2% cases of MTH. In MTH, the total antibioticduration in all surgeries is higher than WRH, significant difference was found only in cholecystectomy(p<0.05). In both hospitals Ampicillin+Cloxacillin was the most commonly used regimen, 12.4% in WRHand 34% in MTH. In WRH, Ciprofloxacin/Cefotaxim was also used by 12.4%. More than 79.1% of thepatients were exposed to, at least, two antibiotics as a prophylaxis in WRH where as more than 63.0% inMTH. Penicillin was found to be mostly used in both hospitals.Key Words: Antibiotic prophylaxis, Surgery.
Highlights
Clinical surgery has witnessed a remarkable reduction in postoperative wound infection during the past 25 years.[1]
Number of antibiotic/s used More than 79.1% of the patients were exposed to, at least, two antibiotics as a prophylaxis in Western Regional Hospital (WRH) where as more than 63.0% in Manipal Teaching Hospital (MTH)
The reason for Caesarean Section (CS) surgery was the most common in WRH might be due to high patient inflow in WRH
Summary
Clinical surgery has witnessed a remarkable reduction in postoperative wound infection during the past 25 years.[1] This reduction has been attributed to improvements in aseptic surgical techniques and use of antibiotic prophylaxis. First generation cephalosporins are considered the most appropriate drugs for the majority of the procedures.[2,3,4]. The recommended beginning time for administration is just before the anesthesia induction, with the exceptions being caesarean section. In the majority of the procedures, a single dose is considered adequate.[5] In spite of extensive knowledge about the effectiveness of antibiotic prophylaxis; administrative regimens are often inappropriate in practice.[6,7,8,9]
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