Utilization Assessment of Surgical Antibiotic Prophylaxis at Ayder Referral Hospital, Northern Ethiopia

Mohamoud, Said Aden; Yesuf, Teshager Aklilu

doi:10.4172/1920-4159.1000220

Cited by 13 publications

(27 citation statements)

References 20 publications

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“…However, overall adherence to all aspects of the guideline occurred in only 28% 11 . Many other studies conducted in multiple countries did report similar results 10,13,17 . The results from multivariable logistic regression analysis showed that several factors emerged as being significantly associated with the appropriateness of antibiotic choice and duration of antibiotic prophylactic administration.…”

Section: Discussionsupporting

confidence: 55%

Antibiotic prophylaxis in clean and clean – contaminated wounds: A descriptive study at University Medical Center Hochiminh city

Nguyen¹,

Nguyen²

2017

Pharm Sci Asia

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Surgical site infections (SSIs) are the most common and costliest healthcare-associated infections. Antibiotic prophylaxis plays an important role in preventing SSIs, especially for clean and clean -contaminated wounds. Despite evidence of effectiveness and availability of guidelines, antibiotic prophylaxis adherence is often suboptimal. This descriptive cross-sectional study was conducted on 311 medical records of patients undergoing surgeries with clean or cleancontaminated wounds at 5 surgery departments at University Medical Center from January to April, 2017. The appropriateness of antibiotic prophylaxis usage was assessed using guidelines from ASHP, Vietnam's Ministry of Health or University Medical Center. Antibiotic prophylaxis was indicated in 99.3% of cases. The mean duration of postoperative use was 3.4 ± 2.6 days. Overall adherence to antibiotic prophylaxis guidelines was observed in 4.8% of procedures. The proportion of cases with appropriate adherence to antibiotic choice, dosing, timing of the first dose, redosing and duration of prophylaxis were 34.1%, 64.0%, 92.0%, 94.2% and 49.2%, respectively. Department of Obstetrics and Gynaecology, wound classification, length of surgery, antibiotics covered by Health Insurance were found to be significantly associated with the appropriateness of antibiotic choice. Adherence to antibiotic prophylaxis guidelines at University Medical Center was low within the study period. The Antibiotic stewardship program should be enhanced and actions to ensure Health Insurance coverage for all antibiotics used for prophylaxis should be implemented to improve the effectiveness and appropriateness of antibiotic prophylaxis.

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Section: Discussionsupporting

confidence: 55%

Antibiotic prophylaxis in clean and clean – contaminated wounds: A descriptive study at University Medical Center Hochiminh city

Nguyen¹,

Nguyen²

2017

Pharm Sci Asia

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“…Data abstraction format was prepared based on previously published studies [ 7 , 9 , 10 ]. It was pretested on 15 patients, modified accordingly and used for data collection.…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies of antibiotic prophylaxis usage have shown wide variation in compliance to guidelines [ 6 ]. Selection, timing and duration of antimicrobial prophylaxis use showed high noncompliance whereas indication and dose were relatively more satisfactory parameters [ 6 , 7 ]. The variation in practice across different setups could be attributed to the variation in the published guidelines, the lack of acceptance of the guideline among the surgeons, and the lack of awareness and availability of the guideline to service delivering professionals or setups [ 6 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic usage in surgical prophylaxis: A prospective observational study in the surgical ward of Nekemte referral hospital

Alemkere

2018

PLoS ONE

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BackgroundSurgical antimicrobial prophylaxis guidelines are considered as important interventional tools for antimicrobial resistance. Guideline compliance was poor across different countries and thus results in an inappropriate and overuse of antibiotics.ObjectiveTo evaluate the selection, timing and duration of prophylactic antibiotic administration among surgical patients in Nekmte referral hospital.MethodProspective, facility based cross-sectional study was conducted from 1st April to 30th June 2017. Data were collected using data abstraction format among surgical inpatients prescribed with surgical antibiotic prophylaxis. Surgical antimicrobial prophylaxis guidelines were used as data assessment protocols. SPSS version 21.0 was used for data entry and analysis. Descriptive statistics and binary logistic regression were used for analysis.ResultsThe median age of the study participants was 35.0 (IQR: 25–50) years with the preponderance (58.8%) of male patients. The median hospitalization period was 8.0 (IQR: 5–11) days. Majority of the participants were from the general surgical ward (60.1%). About 43% of the procedures were clean. Most of the surgical cases were gastrointestinal (39.2%). Only 10.6% of the drug selections comply with American Society of Health-System Pharmacists guideline. Surprisingly, none of the selections were compliant to the national Standard Treatment Guideline of the country. About 84% of the study participants received ceftriaxone. Majority of the prophylactic antibiotics (75.8%) were administered for greater than 24 hours and above half (52.3%) of the antibiotics were administered preoperatively. Emergent surgery procedures (AOR = 2.89, 95% CI: (1.09–9.10) and being a male patient (AOR = 3.10, 95% CI: 1.07–8.98) were associated with inappropriate preoperative antibiotic administration. Patients admitted to the gynecology and obstetrics ward was less likely to receive surgical prophylaxis for greater than 24 hours (AOR = 0.07, 95% CI: 0.01–0.81).ConclusionSurgical antibiotic compliance was far below the guideline recommendation. Patients admitted in the gynecology and obstetrics ward were more likely to comply with the surgical antimicrobial prophylaxis duration recommendation. The timing was most likely to be inappropriate among male patients and patients on emergent surgery. Availability and awareness creation on the antibiotic drugs and the guidelines were important interventions recommended for appropriate surgical antimicrobial use.

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“…SSIs usually occur at or near the incision area within 30 or 90 days, depending upon the procedure performed. SSIs are often localized to the incision site but can also extend into deeper adjacent structures [2].…”

Section: Introductionmentioning

confidence: 99%

Prospective Observational Study on Antibiotic-Prescribing Pattern and Medication Errors in Surgical Prophylaxis in a Specialty Hospital

N¹,

Sivasakthi²,

Joseph³

et al. 2019

Asian J Pharm Clin Res

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Objective: The objective was to study the antibiotic-prescribing patterns, identify the medication errors and impact of surgical antimicrobial prophylaxis (SAP) in preventing surgical site infection (SSI), and to understand the prescribers’ adherence to surgical prophylaxis guidelines. Methods: The study was conducted for a period of 6 months in all surgical departments of a specialty hospital. Data were collected from inpatients records. Australian guideline for SAP was used to assess the appropriateness in prescribing pattern. The sample size was calculated using Raosoft sample size calculator. Results: A prospective observational study was carried out among 178 patients. Of which, 100 were male and 78 were female. Four hundred and thirty-three antimicrobials were prescribed as pre- and post-operative surgical prophylaxis, among that 87% prescribed by brand name and 13% by generic. Seventy-one percent received single antimicrobial agent preoperatively, of which 99.5% prescribed as parenteral and 0.5% as oral formulation. Most often prescribed antibiotic was cefoperazone (28%) of cephalosporin group. Only 5.6% of cases had compliance with SAP guidelines. In this study, 11 patients affected with SSI due to inappropriate antibiotic selection and non-adherence to prophylactic antibiotic guidelines. Conclusion: The present study revealed that there is a poor compliance to SAP guidelines in terms of inappropriateness in antibiotic drug selection, dose, duration, and omission of drugs. Inappropriateness and non-compliance are mainly due to unavailability of clinical pharmacist to assist the physicians in the selection and administration of correct choice of prophylactic drug and unavailability of proper national or local guidelines. Hence, there is dire need to make local SAP guidelines to improve SAP-prescribing pattern.

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Utilization Assessment of Surgical Antibiotic Prophylaxis at Ayder Referral Hospital, Northern Ethiopia

Abstract: Introduction: Surgical site infection represents a significant burden in terms of patients' morbidity, mortality and hospital costs which can be prevented using prophylaxis.

Cited by 13 publications

References 20 publications

Antibiotic prophylaxis in clean and clean – contaminated wounds: A descriptive study at University Medical Center Hochiminh city

Antibiotic prophylaxis in clean and clean – contaminated wounds: A descriptive study at University Medical Center Hochiminh city

Antibiotic usage in surgical prophylaxis: A prospective observational study in the surgical ward of Nekemte referral hospital

Prospective Observational Study on Antibiotic-Prescribing Pattern and Medication Errors in Surgical Prophylaxis in a Specialty Hospital

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