Abstract
Introduction: Antimicrobials are used before, during and after surgery to prevent infections to decrease the duration of hospital stay, increase surgical outcomes and reduce health-related costs. There is inadequate evidence to determine the effective group of antimicrobials to be used in surgical prophylaxis in our settings. Methods: A hospital-based cross-sectional descriptive study involving antimicrobial prescriptions pattern among 223 surgical patients was undertaken. Information on patient’s demographic variables, diagnosis, type of surgery and wound, perioperative antimicrobial use, postoperative complications and number of antimicrobials prescribed from the essential medicine list were recorded. The antibiotic prescription patterns were assessed based on a comparison with international and national guidelines. Results: Among 223 patients, males were predominant with an overall mean age of 42.77 years. The total number of diagnoses was 30, the commonest being appendicitis (21.52%), urinary stone disease (15.69%), hernia (13.90%) and cholelithiasis (11.65%). The common surgeries performed were emergency appendectomy, hernioplasty and laparoscopic cholecystectomy. Eighteen types of drugs from seven different antimicrobial groups were used perioperatively, out of which 73% and 83% were prescribed based on international and national guidelines respectively. Conclusion: The most common antimicrobial used was third-generation cephalosporin. The postoperative antimicrobial rate was found higher compared to preoperative and intraoperative prescriptions and for a longer duration compared to national and international guidelines.
Highlights
Antimicrobials are used before, during and after surgery to prevent infections to decrease the duration of hospital stay, increase surgical RXWFRPHVDQGUHGXFHKHDOWKUHODWHGFRVWV7KHUHLVLQDGHTXDWHHYLGHQFH WRGHWHUPLQHWKHH൵HFWLYHJURXSRIDQWLPLFURELDOVWREHXVHGLQVXUJLFDO prophylaxis in our settings. $XWKRUDႈOLDWLRQV
Surgical operation refers to procedures performed by surgeons by using instruments to repair or reconstruct the damaged tissue, destroy or restore the integrity of tissues and/or to place an implant in a living body.1 7KH perioperative period relates to the time before, during and after surgical operation
Antimicrobial agents are widely used to prevent and treat infection in surgical operations during the perioperative period.[2,3,4] guidelines (Global guidelines for the prevention of surgical site infection by WHO11), hospital based antibiotic stewardship protocol and National antibiotic treatment guidelines developed by the ministry of health and population (MoHP) Nepal.[12]
Summary
Antimicrobials are used before, during and after surgery to prevent infections to decrease the duration of hospital stay, increase surgical RXWFRPHVDQGUHGXFHKHDOWKUHODWHGFRVWV7KHUHLVLQDGHTXDWHHYLGHQFH WRGHWHUPLQHWKHH൵HFWLYHJURXSRIDQWLPLFURELDOVWREHXVHGLQVXUJLFDO prophylaxis in our settings. $XWKRUDႈOLDWLRQV. Antimicrobial agents are widely used to prevent and treat infection in surgical operations during the perioperative period.[2,3,4] guidelines (Global guidelines for the prevention of surgical site infection by WHO11), hospital based antibiotic stewardship protocol and National antibiotic treatment guidelines developed by the ministry of health and population (MoHP) Nepal.[12] Data was entered in the MSExcel and expressed as mean ± standard deviation (SD). Preoperative and intraoperative use of antimicrobials is intended for prophylactic purposes whereas postoperative use of antimicrobials is for a therapeutic purpose: to treat surgical site infection (SSI).5-77KH JRDOV RI DQWLPLFURELDO administration to surgical inpatients focus on preventing SSI-related morbidity and mortality thereby reducing the economic burden on health care and minimizing WKH PRGL¿FDWLRQ RI SDWLHQWV.
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