Abstract
The spectrum and antibiotic sensitivity of isolated strains vary between departments, hospitals, countries; the discrepancies are related to the use and dosage of these antibiotics. The purpose of our research was to compare the type of pathogens and the susceptibility of the isolated strains, as well as the use of antibiotics in the surgical departments of the Emergency Clinical County Hospital, Oradea, Romania; for one year, all the patients admitted to the mentioned sections were monitored. Antibiotic sensitivity of isolated strains was expressed using cumulative antibiogram. The total consumption of antibiotics was 479.18 DDD/1000 patient-days in the surgical sections. The most commonly used drugs were cephalosporins third and first generation, and clindamycin. Infections of wounds, urinary tract and fluids were most commonly diagnosed, and the most isolated was Escherichia coli, followed by Staphylococcus aureus and Enterococcus faecalis. The most commonly prescribed antimicrobial was ceftriaxone, but its sensitivity was low. This study revealed that the intake of antimicrobials in the surgical sections is increased and the comparison of antimicrobial prescriptions, sensitivity rates, and the spectrum of isolated pathogens showed differences between antimicrobials.
Highlights
Surgical site infection is a major complication of operative procedures, and hospital-acquired infections contribute to morbidity, mortality and healthcare costs
Surgical antibiotic prophylaxis is a solution for preventing the postoperative infections if appropriate antibiotics, dose, durations, surgical procedures are given at the correct time, and it should cover the likely pathogens
In 2017, the overall antimicrobial use at the hospital expressed as the total number of DDD of antibiotics was 114,269, and the overall number of administered defined daily doses (DDDs) per 1000
Summary
Surgical site infection is a major complication of operative procedures, and hospital-acquired infections contribute to morbidity, mortality and healthcare costs. Surgical antibiotic prophylaxis is a solution for preventing the postoperative infections if appropriate antibiotics, dose, durations, surgical procedures are given at the correct time, and it should cover the likely pathogens. Previous studies of antibiotic prophylaxis usage have shown wide variation in selection, timing and duration [1]. Less accepted indications for prophylaxis include clean operations in patients with impaired host immunity or patients from neurosurgery, Antibiotics 2020, 9, 81; doi:10.3390/antibiotics9020081 www.mdpi.com/journal/antibiotics. Surgical antibiotic prophylaxis protocols in hospitals must be regularly reviewed considering the cost of antibiotics therapy, the waste generated by antibiotics consumption [2,3], and the endemicity of pathogens, including colonization especially multidrug-resistant bacteria. Appropriate antibiotic prophylaxis is able to reduce the risk of postoperative infections, but in the same time, antibiotic use increases the selective pressure to arise antimicrobial resistance [4]
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