Background: Prophylactic antimicrobials have an important adjuvant role in the prevention of Surgical Site Infection (SSI), which is one of the most preventable causes of post-operative complication. In India, due to lack of adequate information and guidelines for antimicrobial prophylaxis in surgery there is a need to generate baseline data on the pattern of use of prophylactic antimicrobials. Aims & Objective: This study is aimed to analyze the pattern of surgical chemoprophylaxis and surgical site infection (SSI) rate in patients who underwent elective orthopedic surgical procedure. Material and Methods: A prospective, observational study was performed on patients undergoing surgery, in a tertiary care teaching hospital. Data were collected in a pro-forma which included the patients' details, prescriptions from date of admission to discharge or any other outcome and operative notes. Surgical site infection as defined by Centre for Disease Control criteria was recorded. Results: Total 305 patients were enrolled over a period of one year. In 237 (77.70%) patients antimicrobials prescribed by generic name. In preoperatively and intraoperatively, all the patients received parenteral antimicrobial. Postoperatively, 294 (96.40%) patients received only parenteral antimicrobials while in 11 (3.60%) patients received parenteral antimicrobials followed by oral antimicrobials. Preoperatively antimicrobials started 12 hours prior to surgery. Average duration of antimicrobials given postoperatively was 5.05 ± 1.14 days. Third generation Cephalosporins and Aminoglycosides were prescribed most frequently. Average number of antimicrobials used per patient was 4.40 ± 1.05. In follow up 37 (13.03%) patients developed SSI and most common isolated organism was Staphylococcus aureus. Conclusion: Surgical chemoprophylaxis was inappropriate in terms of choice of antimicrobial agent, timing of administration as well as the total duration of prescription, in majority of the cases, leading to higher SSI. Interventions are warranted to promote the development, dissemination and adoption of evidence based guidelines for antimicrobial prophylaxis.
Background: Analysis of prescription of doctors is done to determine, evaluate, and improve the care of patients in a well-organized way and it estimates on-going practice against a defined standard.
Aim and Objective: The aim of the study was to provide the broad outline of performance and delineate parameter as per the check list of prescription audit.
Materials and Methods: An observational and non-interventional study was carried out from July 2021 to November 2021 at peripheral medical college, Gujarat. Randomly, we have selected 500 prescriptions. This prescriptions were evaluated as per World Health Organization prescribing indicators and then it were analyzed for errors in prescription writing.
Results: In this study, total 500 prescriptions were analyzed and total 1839 drugs were prescribed. Average number of drugs per prescription was 3.67. The percentage of drugs prescribed by generic name was 94.6%. The percentage of encounters with an antibiotic prescribed was 29%. In our prescription audit study, 39.16% (1762 count) prescriptions were non complete and 60.84% (2738 count) prescription were having complete details.
Conclusion: If the drug is prescribe by generic name and from essential drug list chances of dispensing error decrease and hand out of incorrect drug to patient is reduced. Minimizing drug per prescription attenuates chances of drug-drug interactions. Regular prescription audit should be conducted regularly which increase the awareness in prescriber and effective, safe, and economics therapeutic practice.
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