A Drug Utilization Study of Antimicrobials in Major Surgical Patients in Tertiary Care Teaching Hospital- A Prospective Observational Study

Abstract

Introduction: Surgical site infection (SSI) is the most common post-operative complication and represents a significant burden in terms of patient morbidity and mortality, and cost to health services around the world. Appropriate antibiotic prophylaxis has been shown to be effective in reducing the incidence of surgical site infections as studies suggest that 40-60% of these infections are preventable. Aims: To evaluate and compare the utilization pattern of antimicrobial agents (AMA) in surgical prophylaxis use in preoperative, intraoperative and post-operative wards of different specialities. Settings and Design: It is a cross-sectional observational study conducted patients admitted to surgery, orthopaedics, ENT and gynaecology wards in tertiary teaching care hospital. Methods and Material: The study duration was from November 2016-November 2018 (2 years).The data was collected time to time from all the medical records of the patient. The study protocol was approved by the Institutional Ethics Committee. Statistical Analysis Used: Data was collected and compiled using Microsoft Excel 2010 and then analysed by calculating simple proportions, frequency and percentage of various parameters. Results: Out of 386 patients, it was observed that female patients (55.69%) were more than male (44.60%) patients. The majority of surgical wounds were clean (39.11%) and most common antimicrobial used pre-operatively was metronidazole (29.24%) and in the intraoperative and postoperative period was gentamicin (54.28%). Number of DDD for inj.amoxicillin-clavulanic acid 1.2g was 274.4. Conclusions: After observing the trend of use of antibiotics, there is a clear need for the development of prescribing guidelines and educational initiatives to encourage the appropriate use of antimicrobials in surgical period. Also, there is scope for improving prescribing habits among the fraternity and minimizing incidence of resistance to antimicrobials.