Abstract
Introduction: Appropriately administered antibiotic prophylaxis reduces the incidence of surgical wound infection. The timing of antibiotic administration is very critical. The first dose should always be given before the procedure, preferably within 60 minutes before incision. Re-administration at one to two half-lives of the antibiotic is recommended for the duration of the procedure. In general, postoperative administration is not recommended except for cardiothoracic surgeries. Materials and Methods: This is a retrospective study done over a period of 6 months from January 2019 to June 2019 in a tertiary care hospital in Bangalore. A continuous 100 patients who underwent an elective surgery were audited regarding the antibiotic indication, choice, dosage, dosing interval, and timing of first antibiotic administration prior to skin incision and duration of prophylaxis were compared with the CDC guideline recommendations and hospital antibiotic policy. Results: A total of 100 surgeries were audited. Out of this, 4% were clean 84% were clean contaminated 4% were contaminated and 8% were dirty. The most commonly used antibiotics were cephalosporins 74% aminoglycosides 36%, β lactams 14%, and fluoroquinolones 2%. The three parameters tested for adherence showed individual compliance of 92% for appropriate selection of antibiotics, 85% for the appropriate administration, and 56% for the appropriate duration of antibiotics, respectively. Conclusion: The results highlight the challenges of disseminating evidence-based protocols systematically into routine clinical practice. Various measures are needed to improve appropriateness of prescriptions and adherence include the development of evidence-based guidelines in collaboration with surgeons, increased outcome-based research to document benefits of appropriate antibiotic use, continuing education to disseminate information to practitioners etc.
Highlights
Appropriately administered antibiotic prophylaxis reduces the incidence of surgical wound infection
A continuous 100 patients who underwent an elective surgery were audited regarding the antibiotic indication, choice, dosage, dosing interval, and timing of first antibiotic administration prior to skin incision and duration of prophylaxis were compared with the CDC guideline recommendations and hospital antibiotic policy
The current study retrospectively reviewed 100 adult cases who underwent elective surgery in 2019 by picking them randomly from all the surgical departments
Summary
Administered antibiotic prophylaxis reduces the incidence of surgical wound infection. Re-administration at one to two half-lives of the antibiotic is recommended for the duration of the procedure. A continuous 100 patients who underwent an elective surgery were audited regarding the antibiotic indication, choice, dosage, dosing interval, and timing of first antibiotic administration prior to skin incision and duration of prophylaxis were compared with the CDC guideline recommendations and hospital antibiotic policy. Certain risk factors justify the use of prophylaxis for clean procedures as well. For patients with two or more significant risk factors, prophylaxis is acceptable but not strongly indicated. A single dose of antibiotics is acceptable, mechanical cleansing and adherence to guidelines for open management of wounds created more than 12 hours before treatment are the essential elements of prophylaxis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
