Abstract
Appropriate use of surgical antimicrobial prophylaxis can prevent approximately 40 to 60% of surgical site infections. Inappropriate use is associated with emergency of antimicrobial resistance, occurrence of side effects and increased health care cost. We aimed to evaluate surgical antimicrobial prophylaxis use of Hawassa University Referral Hospital against standard guideline Prospective observational study was done on 105 patients who undergone major surgical procedure between March 2 and May 2, 2015. Data was collected from patient medication charts, operational and anesthesia notes, by direct observation and patients’ interview using pre-tested questionnaire. All patients were followed daily before, during and after operation till discharge. We coded and cleaned the data using Epi-Data version 3.1 and exported to SPSS for window version 20.0 software for analysis. Overall adherence to American society of health-system pharmacists (ASHP) for surgical antimicrobial prophylaxis use guideline was not observed for all parameters evaluated. Surgical antimicrobial prophylaxis was indicated only in 85(80.9%) patients but administered in 103 (98.1%) patients. Choice of antimicrobial was discordant for all patients for whom antimicrobial prophylaxis was indicated and administered. Ceftriaxone was the most frequently administered 73(70.9%) antibiotics followed by combination of Ceftriaxone and Metronidazole 25(24.3%). Among 98.1% of patients who took antimicrobial prophylaxis , time of first dose administration and duration of administration were concordant in 38(36.9%) and 19(19.1%), respectively. Overall adherence to ASHP guideline was far from optimal for all parameters evaluated. Key words: Antimicrobial prophylaxis, American health system pharmacists, Ethiopia.  
Highlights
Surgical Site Infection (SSI) is an infection that occurs at or near surgical incision within 30 days of operation or after one year if implant is placed (Larson et al, 1999; Tietjen et al, 2003; WHO, 2009)
We found surgical antimicrobial prophylaxis (AMP) were indicated in 85 patients out of 105 patients as per the American society of health-system pharmacists (ASHP) guideline
The overall adherence to ASHP guideline for AMP use was not observed for all parameters evaluated
Summary
Surgical Site Infection (SSI) is an infection that occurs at or near surgical incision within 30 days of operation or after one year if implant is placed (Larson et al, 1999; Tietjen et al, 2003; WHO, 2009). It is the 3rd commonly reported nosocomial infection accounting or 10 to 40% of all nosocomial infections in most studies done worldwide. The interventions include periodic surveillance system, preparation of the patient before operation, appropriate administration of surgical antimicrobial prophylaxis (AMP), careful and skilled surgical technique and postoperative surgical site wound care (Larson et al, 1999; WHO., 2009; Bratzler and Hunt, 2006)
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