Evaluation of surgical antimicrobial prophylaxis use in Ethiopia: Prospective study

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.

Surgical site infection and antimicrobial prophylaxis prescribing profile, and its determinants among hospitalized patients in Northeast Ethiopia: a hospital based cross-sectional study

“…In our study, the duration of SAP administration was not concordant in 28 (26.8%) of patients. This was consistence with a study conducted at Hawassa University Referral Hospital where the duration of SAP administration is concordant in 18.4% of patients taking antibiotics 22 . However, it was lower than the finding of a study conducted in Palestine where only 31.8% of patients received an antibiotic for an appropriate duration 27 .…”

“…Similar to our study, studies conducted in different parts of Ethiopia reported that a prolonged duration of surgery (more than an hour) was associated with increased risks of SSI 1 , 15 , 20 , 30 . Another study conducted in Hawassa also revealed that the inappropriate use of poor surgical antimicrobial prophylaxis increases the development of antimicrobial resistance, and SSI 22 .…”