PHARMACOECONOMIC STUDY OF PROPHYLACTIC ANTIBIOTICS USED IN THE PREVENTION OF SURGICAL SITE INFECTION IN THE SURGERY DEPARTMENT OF GSVM MEDICAL COLLEGE, KANPUR
Main Article Content
Keywords
Pharmaco-economic Evaluation, Prophylactic antibiotic, Surgical Site Infection, Cost
Abstract
Introduction: A pharmaco-economic analysis is the act of breaking down cost summaries into their constituents and studying and reporting them. Costs are compared to disclose and report on conditions subject to improvements.
Aims & Objectives: to analyze the frequency of different antibiotics used for the prevention of SSIs in study subjects, to assess the total cost of illness associated and to assess the cost minimization analysis associated with Prophylactic antibiotics used for the prevention of SSI.
Material & Methods: An observational prospective study was conducted by the Department of Pharmacology in collaboration with the Department of Surgery, G.S.V.M Medical College, Kanpur from February 2023 to June2024. All their basic personal details and prescribed antibiotics for SSIs were collected and entered in predesigned proforma, Cost minimization analysis was also calculated. Results: Overall, this analysis concluded that antibiotic prophylaxis decreased the incidence of SSIs after elective surgery in most patients while noting a high infection rate in gastrointestinal surgery like appendectomy, gastric, small, and large surgeries. The study concluded that antibiotic prophylaxis with a longer duration and broader spectrum significantly reduces the incidence of SSI in high-risk patients, resulting in a substantial reduction in antibiotic costs as well as hospitalization expenses.
Conclusion: However, while the economic analysis indicates that prophylactic antibiotics are generally cost-effective, the findings also underscore the complexity of balancing clinical benefits with long-term costs. In conclusion, prophylactic antibiotics, when used judiciously, can be a cost-effective strategy for preventing SSIs in surgical patients.
References
2. Ortega, G., Rhee, D. S., Papandria, D. J., Yang, J., Ibrahim, A. M., Shore, A. D., ... & Abdullah, F. (2012). An evaluation of Surgical Site Infections by wound classification system using the ACS NSQIP. Journal of Surgical Research, 174(1), 33-38
3. April 2013 CDC/NHSN protocol corrections, clarification, and additions. Available http://www.cdc.gov/nhsn/PDFs/pscManual/9pscSSIcurrent.pdf. Assessed May 28, 2014.
4. Magill SS, Hellinger W, Cohen J, et al. Prevalence of healthcare associated infections in acute care hospitals in Jacksonville, Florida. Infect Control Hosp Epidemiol 2012;33(3):283–91.
5. Hawn M, Vick CC, Richman J, et al. Surgical Site Infection prevention. Ann Surg 2011;8:494–501.
6. Anthony T, Murray B, Sum-Ping W, et al. Evaluating an evidence based bundle for preventing Surgical Site Infection: a randomized trial. Arch Surg 2011;146(3): 263–9.
7. Jeong WK, Park JW, Lim SB, Choi HS, Jeong SY. Cefotetan versus conventional triple antibiotic prophylaxis in elective colorectal cancer surgery. J Korean Med Sci. 2010;25:429-34.
8. Platell C, Hall JC. The prevention of wound infection in patients undergoing colorectal surgery. J Hosp Infect. 2001; 49:233-8.
9. ASHP Therapeutic Guidelines. Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery. Available from:https://www.ashp.org/ /media/assets/policy guidelines/docs/therap eutic guidelines/therapeutic guidelines antimicrobial prophylaxis surger y.ashx?la=en&hash=A15B4714417A51A03E5BDCAC150B94EAF899 D49B. [Last accessed on 2018 Feb 10]
10. Bratzler DW, Hunt DR. The surgical infection prevention and surgical care improvement projects: national initiatives to improve outcomes for patients having surgery. Clin Infect Dis 2006; 43:322.
11. Urban JA. Cost analysis of Surgical Site Infections. Surgical infections. 2006 Jan 1;7(S1):s19-22.
12. Athony T, Murray B, Sum-Ping W, et al. Evaluating an evidencebased bundle for preventing Surgical Site Infection: a randomized trial. Arch Surg 2011;146(3): 263–9
13. Berríos-Torres, S. I., Umscheid, C. A., Bratzler, D. W., Leas, B., Stone, E. C., Kelz, R. R., ... & Healthcare Infection Control Practices Advisory Committee. (2017). Centers for disease control and prevention Guidelines for the prevention of Surgical Site Infection, 2017. JAMA surgery, 152(8), 784-791.
14. Bangaru H, Gaiki VV, Reddy MVR. Comparative study of single dose preoperative antibiotics versus both preoperative and postoperative antibiotics in laparoscopic appendicectomy for nonperforated appendicitis. International Surgery Journal. September 2017; 4(9):3092
15. Allegranzi B, Bischoff P, de Jonge S, Kubilay NZ, Zayed B, Gomes SM, et al. New WHO recommendations on preoperative measures for surgical site infection prevention: An evidence based global perspective. Lancet Infect Dis 2016;16:e276 87.
16. National Institute for Health and Care Excellence. Surgical Site Infections: Prevention and Treatment. Available from: https://www. nice.org.uk/guidance/cg74. [Last accessed on 2018 Feb 10].
17. Scottish Intercollegiate Guideline Network. SIGN104. Antibiotic Prophylaxis in Surgery. Available from: http://www.sign.ac.uk/assets/sign104.pdf. [Last accessed on 2018 Feb 10].
18. National Centre for Disease Control. National Treatment Guidelines for Antimicrobial Use in Infectious Diseases. Available from: http:// www.pbhealth.gov.in/AMR_guideline7001495889.pdf. [Last accessed in 2018 Feb 10].
19. Heit JM, Stevens MR, Jeffords K. Comparison of ceftriaxone with penicillin for antibiotic prophylaxis for compound mandible fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 83: 423–426.
20. Shinagawa N, Yokoyama T, Takeyama H, Taniguchi M, Mikamo H, Yura J. Fundamental study on the selection of antimicrobial prophylactic agents in abdominal surgery. Jpn J Antibiot. 2007 Aug; 60(4):189-99.
21. Furukawa K, Onda M, Suzuki H, Maruyama H, Akiya Y, Ashikari M, et al. The usefulness of conducting investigations on intra-abdominal bacterial contamination in digestive tract operations. Surg Today. 1999; 29(8):701
22. Eagye, K.J.; Nicolau, D.P. Selection of prophylactic antimicrobial agent may affect incidence of infection in small bowel and colorectal surgery. Surg. Infect. 2011, 12, 451–457. [CrossRef] [PubMed]
23. Shanker PR, Upadhyay DK, Subish P, Bhandari RB, Das B. Drug utilisation among older inpatients in a teaching hospital in Western Nepal. Singapore Med J. 2010 Jan; 51(1):28-34. 70.
24. Ghimire S, Nepal S, Bhandari S, Nepal P, Palaian S. A prospective surveillance of drug prescribing and dispensing in a teaching hospital in western Nepal. J Pak Med Assoc. 2009; 59(10):726-31.
25. Kanji S. Antimicrobial prophylaxis in surgery. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells GB, Posey LM, editors. Pharmacotherapy a Pathophysiologic Approach. 9th ed. New York: McGraw Hill Medical; 2014. p. 1991 2006.
26. Fiore Mitchell T, Pearlman MD, Chapman RL, Bhatt-Mehta V, Faix RG. Maternal and transplacental pharmacokinetics of cefazolin. Obstet Gynecol. 2001;98(6):1075–9.18.
27. Lamont RF, Sobel JD, Kusanovic JP, Vaisbuch E, Mazaki-Tovi S, Kim SK, et al. Current debate on the use of antibiotic prophylaxis for caesarean section. BJOG. 2011;118(2):193–201
28. Hessen M, Klöhr S, Rossaint R, Allegeaert K, Deprest J, Van de Velde M, et al. Concerning the timing of antibiotic administration in women undergoing caesarean section: a systematic review and meta-analysis. BMJ Open. 2013;3(4):e002028
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Arka Das
GSVM Medical College, Kanpur
Dr Virendra Kushwaha
Department of Pharmacology, GSVM Medical College, Kanpur (UP)
Dr Pooja Agrawal
GSVM Medical College, Kanpur
Dr Rajesh Kumar Maurya
GSVM Medical College, Kanpur
Dr Amit Kumar
Rajkiya Medical College, Jalaun
Dr Himanshu Sharma
GSVM Medical College, Kanpur