Use of surgical antibiotic prophylaxis and the prevalence and risk factors associated with surgical site infection in a tertiary hospital in Malaysia

Zammari, Nur Farahiah; Abubakar, Usman; Alhadi, Shahidah Che; Khan, Faiz Ullah

doi:10.1007/s40267-022-00914-w

Cited by 2 publications

(2 citation statements)

References 33 publications

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“…A study in surgical wards found 86% of antibiotics were prescribed for therapeutics, and highlighted significant inappropriate prescribing practices in the wards, indicating a need for improved compliance with guidelines ( Lim et al, 2015 ). Notably, most literature on antimicrobial prescribing in surgical practices in the country focuses on surgical antimicrobial prophylaxis (SAP) ( Gul et al, 2005 ; Oh et al, 2014 ; Fadzwani et al, 2020 ; Zammari et al, 2022 ), leaving the gap in understanding broader antimicrobial prescribing patterns in surgical units.…”

Section: Introductionmentioning

confidence: 99%

Assessment of antimicrobial prescribing patterns, guidelines compliance, and appropriateness of antimicrobial prescribing in surgical-practice units: point prevalence survey in Malaysian teaching hospitals

Jamaluddin,

Periyasamy,

Lau

et al. 2024

Front. Pharmacol.

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Objectives: This study sought to investigate the quality of antimicrobial prescribing among adult surgical inpatients besides exploring the determinants of non-compliance and inappropriate prescribing to inform stewardship activities.Methods: A cross-sectional point prevalence study employing Hospital National Antimicrobial Prescribing Survey (Hospital NAPS) was conducted in April 2019 at two teaching hospitals in Malaysia.Results: Among 566 surgical inpatients, 44.2% were receiving at least one antimicrobial, for a total of 339 prescriptions. Antimicrobials belonging to the World Health Organization’s Watch group were observed in 57.8% of cases. Both hospitals exhibited similar types of antimicrobial treatments prescribed and administration routes. A significant difference in antimicrobial choice was observed between hospitals (p < 0.001). Hospital with electronic prescribing demonstrated better documentation practice (p < 0.001). Guidelines compliance, 32.8% (p = 0.952) and appropriateness, 55.2% (p = 0.561) did not significantly differ. The major contributors of inappropriateness were incorrect duration, (15%) and unnecessary broad-spectrum coverage, (15.6%). Non-compliance and inappropriate prescribing were found to be 2 to 4 times significantly higher with antimicrobial prophylaxis prescription compared to empirical therapy.Conclusion: Antimicrobial stewardship efforts to improve appropriate surgical prescribing are essential. These initiatives should prioritize surgical prophylaxis prescribing, focusing on reducing unnecessarily prolonged use and broad-spectrum antimicrobials, raising awareness among prescribers and promoting proper documentation.

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Section: Introductionmentioning

confidence: 99%

Assessment of antimicrobial prescribing patterns, guidelines compliance, and appropriateness of antimicrobial prescribing in surgical-practice units: point prevalence survey in Malaysian teaching hospitals

Jamaluddin,

Periyasamy,

Lau

et al. 2024

Front. Pharmacol.

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“…In Malaysia, inappropriate use of antibiotics among patients has been reported [20][21][22]. About 50% of antibiotic prescriptions among inpatients are non-compliant with guidelines [20].…”

Section: Introductionmentioning

confidence: 99%

Treatments and Predictors of Mortality for Carbapenem-Resistant Gram-Negative Bacilli Infections in Malaysia: A Retrospective Cohort Study

et al. 2022

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This study evaluated the treatments, mortality rate and patient-related factors associated with mortality. This is a retrospective study involving hospitalised patients with infections caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) in a tertiary hospital in Malaysia from January 2018 to June 2020. A clinical pharmacist reviewed patients’ electronic records and collected the data according to a pre-designed form. Data were analysed using both descriptive and inferential tests. The study included 145 patients with CR-GNB infections including 77, 40 and 28 Acinetobacter baumannii, enterobacteriaceae and Pseudomonas aeruginosa, respectively. The mean age was 57.9 ± 15.8 years. Pneumonia (40.7%) and bacteremia (25.5%) were the most common infections. Meropenem (24.7%) and piperacillin-tazobactam (20.4%) were the most commonly used empiric antibiotics while colistin (63.3%) and amikacin (8.3%) were the most common definitive antibiotics. The mean duration before active antibiotics was 4.6 ± 3.3 days. Overall, the in-hospital mortality rate was 41.4%. Multivariate logistic regression analysis showed that intensive care unit (ICU) admission (adjusted odds ratio (AOR): 5.201; 95% confidence interval (CI): 1.603–16.872; p = 0.006), sepsis/septic shock (AOR: 3.430; 95% CI: 1.021–11.522; p = 0.049) and elevated serum creatinine (AOR: 2.752; 95% CI: 1.005–7.536; p = 0.049) were independently associated with mortality. The mortality rate among patients with CR-GNB infection is high. A high rate of inappropriate antibiotic use was observed, including combination antibiotic therapy and delays in starting active antibiotics. Mortality was significantly associated with ICU admission, sepsis/septic shock and elevated serum creatinine.

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Use of surgical antibiotic prophylaxis and the prevalence and risk factors associated with surgical site infection in a tertiary hospital in Malaysia

Cited by 2 publications

References 33 publications

Assessment of antimicrobial prescribing patterns, guidelines compliance, and appropriateness of antimicrobial prescribing in surgical-practice units: point prevalence survey in Malaysian teaching hospitals

Assessment of antimicrobial prescribing patterns, guidelines compliance, and appropriateness of antimicrobial prescribing in surgical-practice units: point prevalence survey in Malaysian teaching hospitals

Treatments and Predictors of Mortality for Carbapenem-Resistant Gram-Negative Bacilli Infections in Malaysia: A Retrospective Cohort Study

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