PRESCRIBING PATTERN OF ANTIBIOTICS AMONG PRE AND POST-OPERATIVE CAESAREAN SECTION AMONG PRACTICING OBSTETRICIAN

Main Article Content

Dr. Shruti Gupta
Dr. Ambrish Kumar Gupta
Dr. Parul Kamal

Keywords

Caesarean section, Cephalosporins, Aminoglycosides, Metronidazole

Abstract

Aim: The aim of present study is to evaluate the prescribing pattern and rational use of antibiotics in post-operative caesarean section (CS) in tertiary care hospital.


Materials and methods: Prospective observational case report study was conducted from July-2021 to November-2021. The complete data of 75 women who had undergone caesarean section like,  age, line of management, number of antibiotic being prescribed before C section and  during discharge, adverse effects and complications occurred during study was collected. Data was entered in MS excel sheet and analysed by descriptive statistics.


Results: Total of 75 post-operative caesarean section inpatients data was collected and analysed in the study. Cephalopelvic disproportion was the most common cause of C-section. Among 75 women, 31% were belongs to age group 25 to 30 years and remaining 69% were belongs to age group 31 to 35 years. Before C-section to prevent infections, most commonly prescribed antimicrobial agents were IIIrd generation Cephalosporin’s (91.11%) and metronidazole (79.35%). Some patients also received other groups of antibiotics like Aminoglycosides (20.54%) and Penicillin (2.94%). During discharge most commonly penicillin were given (67.1%) followed by aminoglycosides (44.1%), tinidazole 32.35%, metronidazole (23.52%) and cephalosporin’s 23.52%. All the drugs were prescribed in generic name and in small letters of English.


Conclusion: Usage of antimicrobial agents has become common either to prevent or to treat infections during or after cesarean section but, aseptic precautions must be the first approach to prevent infections. Prescribers should be cautious while prescribing antibiotics and also make sure the rationality of prescription

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References

1. Williams MJ, Carvalho Ribeiro do Valle C, Gyte GML. Different classes of antibiotics given to women routinely for preventing infection at caesarean section. Cochrane Database Syst. Rev. 2021; 3:CD008726. doi: 10.1002/14651858.CD008726.pub3.
2. Weckesser A, Farmer N, Dam R, Wilson A, Morton VH, Morris RK. Women’s perspectives on caesarean section recovery, infection and the PREPS trial: a qualitative pilot study. BMC Pregnancy Childbirth. 2019;19(1):245. doi:10.1186/s12884-019-2402- 8.
3. Eddy K, Vogel J, Comrie-Thomson L, Zahroh R, Bonet M. Preventing infection at birth with antibiotics and antiseptics: a mixed-methods systematic review (protocol). PROSPERO. 2020;CRD42020191746 (ID=CRD42020191746, accessed 23 March 2021).
4. Briscoe KE, Haas DM. Developing a core outcome set for cesarean delivery maternal infectious morbidity outcomes. Am J Perinatol. 2020;37(4):436–52. doi:10.1055/s-0039-1681095.
5. Alekwe LO, Kuti O, Orji EO, Ogunniyi SO. Comparison of ceftriaxone versus triple drug regimen in the prevention of cesarean section infectious morbidities. J Matern Fetal Neonatal Med. 2008;21(9):638–42. doi:10.1080/14767050802220490.
6. Evers S, Goossens M, de Vet H, van Tulder M, Ament A. Criteria list for assessment of methodological quality of economic evaluations: Consensus on Health Economic Criteria. Int J Technol Assess Health Care. 2005;21(2):240–5.
7. Benigno BB, Ford LC, Lawrence WD, Ledger WJ, Ling FW, McNeeley SG. A doubleblind, controlled comparison of piperacillin and cefoxitin in the prevention of postoperative infection in patients undergoing cesarean section. Surg Gynecol Obstet. 1986;162(1):1–7.
8. World Health Organization Model List of Essential Medicines for Children. 7th List 2019. Geneva: World Health Organization; 2019 (https://www.who.int/publications/i/ Item/WHOMVPEMPIAU201907, accessed 23 April 2021).
9. Knowles R, Sharland M, Hsia Y, Magrini N, Moja L, Siyam A, et al. Measuring antibiotic availability and use in 20 low- and middle-income countries. Bull World Health Organ. 2020;98(3):177–87C. doi:10.2471/BLT.19.241349.
10. Tunger O, Dinc G, Ozbakkaloglu B, Atman UC, Alqun U. Evaluation of rational antibiotic use. Int J Antimicrobial Agents. 2000;15(2):131-5.
11. WHO recommendation on antibiotics for uncomplicated vaginal birth. Available at: https://extranet.who.int. Accessed on 17th February 2018.
12. Neeta Sawhney, Vineeta Sawhney, Vijay Khajuria. Prescribing pattern of antibiotics among postoperative patients admitted in gynaecology and obstetrics department of tertiary care hospital in Northern India. Int J Basic Clin Pharmacol. 2020 Feb;9(2):300-304.
13. Sharma M, Sanneving L. Antibiotic prescribing in women during and after delivery in a non-teaching, tertiary care hospital in Ujjain, India: a prospective cross-sectional study. J Pharma Policy Pract. 2013;6:9.
14. Agrawal M, Nayeem M, Shafhi MM, Makeen HA, Sumaily MJ, Gupta N. Prescribing pattern of drugs in the department of obstetrics and gynaecology in expecting mothers in jazan region, KSA. Int J Pharma Pharma Sci. 2014;6(1):658-61.
15. Liu R, Lin L, Wang D. Antimicrobial prophylaxis in caesarean section delivery. Exp Therap Med. 2016;12(2):961-4.
16. Bhingare PE, Bashir MSM, Khade A, George S. Prescription pattern in Gynaecology – A retrospective study in a south Indian Teaching Hospital. J Cont Med A Dent. 2014;2(2):51-4.
17. Dwivedi YK. Prescribing pattern of antimicrobial agents in patients suffering from PID in a tertiary care teaching hospital. Indian J Basic Applied Med Res. 2013