ANTIBIOTIC STEWARDSHIP IN SURGICAL PROPHYLAXIS: A STUDY OF PRESCRIPTION TRENDS IN A TERTIARY CARE FACILITY
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Keywords
Surgical site infection, Antibiotics, Surgical prophylaxis
Abstract
Background: Wound infections are the commonest hospital acquired infections in surgical patients. They result in increased antibiotic usage, increased costs and prolonged hospitalization. Surgical prophylaxis means prevention of infection at the site of surgery that includes, infection at site of incision and infection of deeper tissues handled during surgery.
Prophylaxis may decrease hospital stays and expedite the return to regular activities on discharge. Therefore, the present study was undertaken to observe and analyse antimicrobial prescription pattern in patients that had undergone surgery at a tertiary care hospital. Methods: A prospective observational, noninterventional, descriptive study was conducted from January to August 2024. Patients who were more than 18 years of age admitted in general surgical wards receiving at least one dose of any class of antibiotics orally or intravenously were included in this study. During the study, 493 prescriptions were studied, and patient records were collected and analyzed.
Results: Among the patients, 62% were male, and 52.94% were aged 25-50 years. Prophylactic antibiotics were administered to 425 patients (86.2%), with cephalosporins (94.02%) and nitroimidazoles (73.33%) being the most commonly prescribed antibiotic groups. Of the 425 patients, 20.22% received monotherapy, while 79.77% received combination therapy. Ceftriaxone alone was used in 69.31%, and Ceftriaxone + Metronidazole in 48.7%. Surgical site infections (SSIs) developed in 51 patients (10.34%). A prior risk factor was identified in 252 patients. Patients with comorbidities were at higher risk of developing SSIs. SSIs were more frequent in contaminated (29.16%) and dirty wounds (26.31%), highlighting the importance of wound classification in SSI occurrence. Additionally, 349 patients (82.11%) received surgical antibiotic prophylaxis (SAP) within 1 hour before the incision. However, 19.35% of SSIs could be linked to receiving antibiotics more than 1hour before incision, and 12.92% of SSIs were associated with emergency surgeries.
Conclusions: Surgical antibiotic prophylaxis (SAP) is essential in preventing surgical site infections (SSIs) by targeting both exogenous and endogenous microorganisms. Administering antibiotics within the critical window—30 to 60 minutes prior to surgery—has proven to be effective in reducing the risk of SSIs. Adhering to evidence-based guidelines for antibiotic selection, timing, and dosage is crucial for optimizing patient outcomes and minimizing infection-related complications.
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Pradnya Deolekar
Dept of Pharmacology, D Y Patil Medical College, Navi Mumbai
Kavitha VD
Dept of Pharmacology, D Y Patil Medical College, Navi Mumbai
Jyoti Amol Pawar
Dept of Microbiology, D Y Patil Medical College, Navi Mumbai
Sandesh Deolekar
Dept of Surgery, D Y Patil Medical College, Navi Mumbai
Prateek DT
Dept of Pharmacology, D Y Patil Medical College, Navi Mumbai
Atharva Dahibhate
Dept of Pharmacology, D Y Patil Medical College, Navi Mumbai
Movva Navya
Dept of Pharmacology, D Y Patil Medical College, Navi Mumbai
Akash Sinha
Dept of Pharmacology, D Y Patil Medical College, Navi Mumbai
Yuvraj Sawant
3rd Year MBBS, D Y Patil Medical College, Navi Mumbai
Jasmit Kaur Puri
Final year MBBS, D Y Patil Medical College, Navi Mumbai
Nidhi Hrishikesh Vadhavekar
Intern, D Y Patil Medical College, Navi Mumbai
