European Journal of Biomedical and Pharmaceutical Sciences

PATTERNS OF PRESCRIPTION AND USAGE OF ANTIMICROBIAL AGENTS FOR THE PROPHYLAXIS OF SURGICAL SITE INFECTIONS IN A TERTIARY CARE HOSPITAL IN KARNATAKA, SOUTH INDIA

Dr. Noble. J. Thaikattil*, Dr. Rajendra Holla, Dr. K R Bhagvan, Dr. Advaitha M.V, Dr. Nikhilesh Anand, Dr. Navya J Thaikattil

ABSTRACT

Background: Surgical Site Infections (SSI) are considered to be the most common post-operative complication and second most common cause of nosocomial infections. The administration of empirical antimicrobials preoperatively is one of the measures used to overcome risk of developing SSI .There is a need to generate basic database on the current prescription pattern of prophylactic antimicrobials in institutions all over India so that it can be used for understanding the ongoing trend before any organization can put forward recommendations or provide national guidelines. Aim: This study aims to explore the current prophylactic antimicrobials prescription pattern followed in surgical department in a tertiary care hospital in Karnataka, South India. Methodology: A prospective study was carried out in Surgery department of a tertiary care hospital for a period of 12 months. Inpatients undergoing surgical procedures in Surgery department were included and data collected on baseline characteristics, surgical procedure, choice of prophylactic antibiotic, timing of administration, duration and dosage. Each patient was followed up till discharge from hospital. Institutional ethical clearance was obtained. Results: Out of 448 subjects 64.1 % were males and 35.9 % were females. Their ages ranged from 18 to 60. Majority (78%) had no baseline comorbidities. All subjects received prophylactic antibiotics, four subjects received oral antibiotics and others (444) intravenous antibiotics. Cephalosporin (90%) was the most frequently used antibiotic. Metronidazole was the most frequently used (80%) additional drug. There was inverse association with number of antibiotics prescribed and presence of co-morbidities (p=0.002).Subjects with co-morbidities had a longer mean duration of hospital stay (p<0.001). Majority (91.9%) of the subjects continued to receive antibiotics even after 24 hours of surgery. Five (1.1%) subjects developed SSI. Conclusion: The core concern of this study was universal prescription of prophylactic antibiotics and the extended duration of the antimicrobial prophylaxis. Due to lack of a standard guideline in India wide variation is seen in selection, duration and dosing of surgical antimicrobial prophylaxis (AMP) across the country and the study highlights the need to formulate and adopt unified guidelines.

Keywords: Antimicrobial prophylaxis, Prescription Pattern, Surgical Site Infections.