Prophylactic antibiotics prescription in ear, nose, throat and ophthalmologic procedures; an Iranian university hospital situational analysis

Abstract

Introduction: Different prophylactic methods are introduced to prevent surgical site Infection. This study was conducted to evaluatesituation of prophylactic antibiotics (PA) usage in an Iranian university hospital. Aims: A cross sectional study. Methods: This study obtained data from 1010 patients' medical files in 2015. These patients were admitted to a university otolaryngology (ENT) and ophthalmology hospital in north of Iran. Data from ordered prophylactic antibiotics considering induction time, type of antibiotic, duration of use, dosage amount and intervals was obtained to compare with international and national guidelines. Data analysis was performed by using Chi-square test at significance level of 95%. Results: 402 (39.8%) patients were male and 608 (60.2%) ones were female. Mean age and standard deviation was 41.8±22.3 years old, and most participants were in 20-39 years of age. Ophthalmic and ENT related procedure was respectively conducted for 41.7% and 58.3% of patients. Septorhinoplasty and phacoemulsification were the commonest procedures. Totally 999 (98.9%) people received prophylactic antibiotics. Intravenous Cefazolin (for ENT procedures) and topical eye drop of Chloramphenicol 0.5% were prescribed mostly. We found poor accommodation between antibiotic use and guidelines for prophylaxis, mostly in case of duration of apply. Conclusion: Ordered prophylactic antibiotics is not as need as prescribed. Also, accommodation between prescription of antibiotics and available scientific guidelines was improper in this study.

Prophylactic use of antibiotics as per SIGN 104 guidelines versus routine antibiotic prophylaxis for prevention of surgical site infection in clean and clean contaminated ENT surgical procedures: a comparative study

“…22 Similarly, Habibi et al did not recommend routine use of prophylactic antibiotics after evaluation of 1010 procedures in their study. 23 There is no universal agreement on the choice of antibiotic for prophylactic use. For example, cefazolin has been commonly used for antibiotic prophylaxis, but, Otake et al showed in their study that oral azithromycin had equal efficacy as intravenous cefazolin in preventing surgical site infection in tonsillectomy patients.…”