Prescribing practices of antimicrobial prophylaxis in older patients

What is it about?

To investigate the prescribing practices of antimicrobial prophylaxis and adherence to recommended protocols in older patients in the surgical wards.researchers seleced 240 surgical procedures retrospectively for patients aged 65 years and older admitted to four surgical specialties (abdominal, orthopaedic, urological and neurosurgery) during one year. The different parameters of antimicrobial prescription were compared with international clinical practice guidelines.There were more ‘clean’ surgical wound procedures (n=104; 43.3%) than ‘clean contaminated’ (n=97; 40.4%) and most of these were elective surgical procedures (n=226; 94%). The indication, selection, route, dose, and timing of antimicrobial were found to have adhered with the standard guidelines in 89.6%, 32.5%, 100%, 100% and 55.3% of cases, respectively (optimal value 100%). A statistically significant difference was observed between antimicrobial practices and surgical procedures (P< 0.001). The commonly prescribed antimicrobials were ceftriaxone followed by cefazolin.about 89% of participants who underwent surgical procedures received antimicrobials. The selection of therapeutic agent, the timing and use of broad-spectrum antimicrobial were the common problems.

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Why is it important?

Adherence with standard antimicrobial prophylaxis protocols is an essential element of hospital policy and patient safety. Little is known about antimicrobial prophylaxis for prevention of surgical site infections in older patients in Pakistan, as well as globally.

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