A Prospective Study of the Pattern of Use of Antimicrobial Agents in Surgical Prophylaxis in a Tertiary Care Centre

Objectives: Consciousness during anesthesia is a non-reversible complication that may expose the patient to severe, long-term, emotional injuries and post-traumatic stress. Therefore, this study aimed to compare the effect of two methods of induction maintenance of anesthesia with thiopental sodium-remifentanil and propofol-alfentanil on consciousness during orthopedic surgery using a bispectral index (BIS) device. Methods:In this triple-blind clinical trial, 111 patients who underwent orthopedic surgery in Dezful Hospital (southwestern Iran) were investigated. Patients were randomly assigned into two groups: The intervention Group "A" received thiopental for the induction of and fentanyl for maintenance and intervention Group "B" received propofol and alfentanil. The patients underwent BIS monitoring before the end of surgery, and the BIS value was recorded. The Brice questionnaire was used to measure the consciousness. The data were analyzed using repeated Measure ANOVA test. Results:In the intervention Groups A and B, the mean BIS score was 63.71 and 60.62 in the first 5 min after surgery, reaching 65.25 and 67.73 60 min after surgery, respectively. The results of repeated measures ANOVA test showed that the mean BIS score was significantly different from the preoperative value (baseline) group during repeated measurements after surgery (5, 10, 15, 30, 40, and 60 min) (p<0.001). According to the Brice questionnaire, the prevalence of hearing loss during surgery showed a statistically significant difference between the two intervention Groups (A and B), and the incidence of hearing during surgery in intervention Group "B" was approximately 3 times higher than intervention Group "A" (odds ratio=3.22, 95% confidence interval: 1.32-7.79). Conclusion:The results indicate that none of the induction and maintenance pharmacologic methods have any superiority in terms of optimal depth of anesthesia in patients undergoing orthopedic surgery.

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“…However, in the group anesthetized with BIS monitor, none of the patients experienced anesthesia awareness [8,25].…”

Section: Discussionmentioning

confidence: 99%

Comparing the Effect of Two Methods of Anesthesia Induction on Consciousness During Orthopedic Surgery

Nanaei

Adarvishi

Dastoorpoor

et al. 2018

Asian J Pharm Clin Res

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“…Female were relatively higher than male as they were 55 (55%), then male as they were 45 (45%), compared to another study Napolitano In our study most of the hospitalization were due to fracture 22%, cholelithiasis16%, 16% patients had renal stone and adenomyosis 12% this is because study center is referred hospital a large number of cases indicate insufficient healthcare facilities at the region furthermore, excess cares of renal stone adenomyosis, cholelithiasis might be due to lack of awareness to get early help as well, poverty may be a reason of late arrival of the cases. 11,12 This is usual trends as the fecund age group that is actively involved in socioeconomic activity, making them susceptible to disease which may further needs surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Brethis CS. 11,12 conducted at Mahavir Institute of Medical Sciences, Hydrebad India. Sviestina I et al, conducted at Public Health and Epidemiology Department, Riga Stradinš University, Dzirciema iela, Riga, Latvia.…”

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confidence: 99%

“…In contrast of our result study conducted by Rehan HS et al, at lady hardinge medical college and SSK hospital, New Delhi India in which 41% patients received two drug, 28% received one drug antibiotic remaining 19 % patients received three drugs and 1 patient received 4 drugs for prophylaxis while in another study conducted by Brethis CS et al, conducted at Mahavir Institute of Medical Sciences, Hydrebad India. 12,17 In which 12.6% of the patient prescribed with monotherapy remaining 87.4% were received more than two antibiotic combination.…”

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confidence: 99%

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Evaluation of prescription pattern of antibiotics for surgical prophylaxis in secondary care hospital

Joshi¹,

Rizwan²,

Kothiyal³

et al. 2017

Int J Basic Clin Pharmacol

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Background: Antibiotic prophylaxis is the prevention and in incidence of surgical site infection. This study evaluates the rational use of antibiotics prophylaxis prior to surgery amongst hospitalized patients. Objectives of the study were to investigate the utilization and evaluation pattern of antibiotics for surgical prophylaxis in surgery department.Methods: A prospective observational study was conducted on 100 patients receiving antibiotics in the Department of Surgery of Brijesh Hospital Ramnagar (Nainital) Uttarakhand. Patient undergoing antibiotic prophylaxis treatment were included in the study, exclusion of those patients who had age less than 18, patients with psychiatric disease and those patients not willing to sign on inform consent form.Results: The result observed in 100 patients follow up 8 weeks and evaluate the appropriate use of prophylaxis of antibiotics majority of patients were age group 18-30 years, followed by 41-50 years, 51-60 years, majority were reported in female patients than male, higher utilization of cephalosporins were commonly prescribed due to their relatively lower toxicity and broader spectrum activity and broader coverage of organism for several serious gram negative infection 30 (30%) patients were prescribed penicillin with aminoglycosides, 10 (10%) patients were prescribed with nitroimidazole antibiotics.Conclusions: The overall scenario of antibiotic usage in a Hospital was as per standard recommendations and all the antibiotics used were according to their standard adult and titrated doses and frequencies. In this study we found that Cephalosporines, Penicillins, Aminoglycosides and Nitroimidazole were mostly used classes of drug. Adverse Drug Reactions were minor and well managed.

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“…Medical data of patients who performed surgery in the surgical clinic included patient demographics, kind of surgical procedure, choice of antibiotic regimens, time of administration, and dosage were collected retrospectively. The compliance of prophylactic antibiotics administration was based on Scottish Intercollegiate Guidelines Network (SIGN) [9]. …”

Section: Methodsmentioning

confidence: 99%

Cross–sectional Study of Surgical Prophylactic Antibiotic Administration in Marzoeki Mahdi Hospital, Bogor, Indonesia

Rokhmah

Andrajati

Radji

2017

Asian J Pharm Clin Res

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Objective: This study was conducted to evaluate the prophylactic antibiotic administration in the surgical clinic of Dr. H. Marzoeki Mahdi Hospital, Bogor, Indonesia. Methods:The data were assessed from the medical records of all patients who underwent surgery from January to December 2013 retrospectively. Antibiotic prophylaxis was assessed based on the Scottish Intercollegiate Guidelines and the National Guidelines of Antibiotic Usage, which includes the type, time, and duration of prophylactic administration of antibiotics.Results: A total of 577 patients were included in this study, consisting of 202 men and 375 women. The most frequently performed surgery is a common surgery 347 (60.1%), followed by obstetric operations 176 (30.5%), and orthopedic surgery 54 (9.4%). In this study, all patients received prophylactic antibiotics before surgery. Cefotaxime (87.8%) was the most commonly used antibiotics for surgical prophylaxis. Of the 577 patients, only 1.1% of patients reported with surgical site infection (SSI). Conclusion:This study shows that adherence to the guidelines of surgical antibiotic prophylaxis is still very low. Therefore, efforts should be made to increase the compliance of using antibiotic prophylaxis in accordance with standard guidelines to improve the rational use of antibiotics.

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A Prospective Study of the Pattern of Use of Antimicrobial Agents in Surgical Prophylaxis in a Tertiary Care Centre

Cited by 5 publications

References 10 publications

Comparing the Effect of Two Methods of Anesthesia Induction on Consciousness During Orthopedic Surgery

Comparing the Effect of Two Methods of Anesthesia Induction on Consciousness During Orthopedic Surgery

Evaluation of prescription pattern of antibiotics for surgical prophylaxis in secondary care hospital

Cross–sectional Study of Surgical Prophylactic Antibiotic Administration in Marzoeki Mahdi Hospital, Bogor, Indonesia

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