Journal des maladies infectieuses et de la médecine préventive
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Surgical Anti-Microbial Prophylaxis and Incidence of Surgical Site Infections: AHospital Based Prospective Study

Raju Niraula*, Ramesh M. Tambat, Sunita Devkota, Ramu Gupta

Introduction: Health Care-Associated Infections (HAI) remain as an important public health concern. Amongst the prominent HAIs, Surgical Site Infections (SSL) contributing to substantial rate. of mortality, significant morbidity. Considerable prolongation in length of hospitalization and added treatment expenses. Wound infections are the commonest hospital-acquired infections in surgical patients. They result in increased antibiotic usage, increased costs and prolonged hospitalization. Appropriate antibiotic prophylaxis can reduce the risk of postoperative wound infections, but additional antibiotic use also increases the selective pressure favoring the emergence of antimicrobial resistance. Approximately 30%-50% of antibiotic use in hospital practice is now for surgical prophylaxis. However, between 30% and 70% of this prophylaxis is inappropriate. Most commonly, the antibiotic is either given at the wrong time or continued for too long.

Aim: To evaluate the pattern of antimicrobial prophylaxis in general surgery. To assess the frequency of post-operative infection. To assess the prevalence of surgical site infection. Finding and comparing frequency of risk factors, incidence of SSI, type of antibiotics used.

Methodology: A hospital based prospective observational study was carried out for a period of 6 months in Jayanagar General Hospital, by enrolling In-patients considering study criteria. During the study. 180 prescriptions were studied and patient's record were collected and analyzed using spss and Microsoft excel.

Results: 180 patients were enrolled in the study. Majority of the prescription were of females (51.11%) compared to males (48.89%). The incidence of SSI was similar to both male (5.45%) and female (5%) in general surgery Staphylococcus aureus (52%) and Pseudomonas aeruginosa (15.79%) are found to be the most common microorganism causes SSI. Increased chances of infection were due to associated risk factor like DM, HTN, Anaemia eye. Patients with advanced age >50 years) were most susceptible to SS rather than younger age. Infected patient was treated with more than two numbers of antibiotics where non infected with single or double antibiotics. Hospital stays increases with incidences of SSI.

Conclusion: The study clearly concluded about the overuse and inappropriate choices of antibiotics. Hence, our study also suggests following the guidelines for rational use of antibiotics and minimizing the inappropriate antibiotic use is the best way to minimize the chances of SSI. Hospital should establish prophylactic antibiotics guideline which should be open and accessible by every member of the surgical team. Medical checklist should be practiced effectively. Frequent audit of prophylactic antibiotic use is needed to improve proper practices (prophylactic antibiotics uses). Surgeons should adhere to prophylactic antibiotics guidelines.