While timing of surgical antibiotic prophylaxis in clean surgeries is highly compliant, the prolonged use of broad-spectrum and oral antibiotics highlights a need for improved antimicrobial stewardship.
Introduction: There has been a rise in the use of broad spectrum antibiotics in patients undergoing surgeries in perioperative period including clean surgeries. The use of such antimicrobials is also found to be longer than recommended and is responsible for emregence of multi drug resistant infections. These add to antibiotic related complications and cost as well. Aim: To study the type of antibiotic prescription in patients undergoing clean surgeries and assess compliance with antibiotic policy and frame recommendations for improvements if any. Method: Fifty five patients were prospectively evaluated for perioperative antibiotics prescriptions and followed up till discharge/1 month for any nosocomial infections or other complications. The kind and duration of antibiotics were noted and assessed for extent of compliance to antibiotic policy. Results and Discussions: Compliance to perioperative surgical prophylaxis in time was good (91%) as per the protocol and all patients received prophylaxis. Broad spectrum antibiotics were used in almost 50% cases and duration was prolonged compared to the prescribed protocol. Prescription of oral antibiotics was continued in 72.7% % cases(40/55). There was no increased incidence of health care associated infections(HAI) in these patients. Conclusion: Compliance to Surgical antibiotic prophylaxis practices in clean surgeries is good in the hospital Broad spectrum antibiotics were in use in more than half cases and oral antibiotics were prescribed at discharge in most patients which is not in accordance with the protocol. The incidences of HAIs in these cases were not increased. Regular audit and continued training of all stake holders is necessary to raise awareness and improve practices for antimicrobial stewardship.
Sinha et al. (Sun,) studied this question.