Assessment of rational use of antibiotics in surgical prophylaxis and post- operative cases at district hospital Gulbarga

Abstract

Background: Postoperative wound infections are the major cause of morbidity in surgical patients. The use of pre and peri-operative antibiotics, with sound and appropriate principles of prophylaxis are applied can result in a reduced risk of postoperative infection. Although the principles of antimicrobial prophylaxis for surgical procedures have been well defined for many years, inappropriate and excessive use of antimicrobials for this purpose remains widespread.Methods: This was a prospective study conducted on the inpatients undergoing surgical procedures. ASHP (American Society of Health System Pharmacists) and SIGN (Scottish Intercollegiate Guidelines Network) guidelines were used as the standard guideline.Results: Of the total 150 procedures reviewed, 130 procedures were entered in the analysis. Of these procedures, the rate of totally compliant prescriptions was 28.46%. Totally in 93 (71.53%) patients, the antibiotic prophylaxis was found to be inappropriate. In 36 (27.70%) patients, indication for antibiotic prophylaxis was not proper and in total 38 (44.19%) patients, where antibiotic prophylaxis was justified and given, proper antimicrobial agent was not used.Conclusions: Instead of existence of the written guidelines for antimicrobial surgical prophylaxis there are significant deviations from the recommendations in current clinical practice. Adherence of antibiotic prophylaxis to these guidelines is needed to be evaluated routinely in clinical practice.