What is it about?
The appropriate use of antibiotics is the main strategy of Antimicrobial stewardship program. This study was planned to evaluate the quality of antibiotic prescriptions, its adherence with standard guidelines and surgeons’ perception regarding antibiotic use in surgeries.A total of 866 eligible surgical cases out of 1015 were investigated. An acute appendectomy (n= 418; 48.2%) was most common surgical intervention followed by laparoscopic cholecystectomy (n= 278; 32.1%) and inguinal hernia (n= 170; 19.7%). About 97.5% of patients received antibiotics. Among these, 9.5% adhered according to guidelines with respect to correct choice, 40% for timing, 100% for dose and route (optimal value 100%). The ceftriaxone (J01XD04; n= 503; 59.5%) was most frequently prescribed antibiotic. A 200 participants (response rate 70.6%) filled out a validated questionnaire (internal consistency; α ≥ 0.7). One hundred and thirty-eight (69%) reported the overuse of antibiotics and most of them (97%) preferred broad-spectrum antibiotics instead of narrow-spectrum. The participants reported that non-availability hospital-based guidelines (n=193; 96.5%), prescribing of antibiotics without guidelines (n=186; 93%), underestimation of infection (n=177; 88.5%), lack of consensus (n=135; 67.5%) and poor awareness about guidelines (n=122; 61%) were the main determinants in their health care settings.
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Why is it important?
The compliance of Surgical antibiotic was far below the recommendations of guidelines. The inappropriate choice, the timing of administration, overuse of antimicrobials, prescribing of antibiotics without guidelines, poor awareness, underestimation of infection, lack of consensus and non-availability of hospital-based guidelines were the main problems observed in this study. Good prescribing practices are crucial for patient safety and better health outcomes. Although, prescribers still rely on their own personal experiences while prescribing therapeutic agents. Surgeons are at the forefront in treating patients with infections therefore, the direct involvement of surgeons with knowledge in surgical infections can be highly impactful.
Perspectives
This study focused on specific three common abdominal surgeries, quality of antibiotic prescription, compliance rate with standard protocols and surgeon’s perception in two tertiary care hospitals. As to the best of our knowledge, no previous studies have been focused on antibiotic utilization in selected abdominal procedures and surgeons, in a global or local perspective. The study has a novel concept, to documented the prescribing practices in three common abdominal surgical procedures and compare with International standard guidelines. This study also provides useful information to understand the perception of surgeons. Further, a sample size of 866 prescriptions and surgeons is a huge sample that result in most authentic findings. Data collection from 2 tertiary care teaching hospitals was also a challenging task. The use of International evidence-based guidelines was best steps to strengthen the study. Due to which areas associated with drug use problems were identified and the degree of problems were also measured. Outcomes of present study add to a growing literature, particularly around medicine use and pharmaceutical health systems in developing countries.
Zakir Khan
Cukurova Universitesi
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This page is a summary of: Utilization of Antibiotic Prophylaxis in Three Common Abdominal Surgeries, Adherence to Standard Guidelines and Surgeons' Perception in Teaching Hospitals, Islamabad, Pakistan, June 2019, MDPI AG,
DOI: 10.20944/preprints201906.0119.v1.
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