Assessment of Adherence to Surgical Antimicrobial Prophylaxis Guidelines: A Prospective Observational Study in A Tertiary Care Hospital

Background: Surgical site infection (SSI) is leading cause of hospital acquired infection leading to extended stay in hospital and higher mortality rate thereby increasing financial and clinical burden. Surgical antimicrobial prophylaxis (SAP) is an important preventive measure helpful in reducing the incidence of SSI. There are numerous guidelines which emphasize on rational and judicious use of antimicrobials to prevent SSIs. Hence, we aimed our research to study practices of AMA use for prevention of SSI at our tertiary care teaching hospital, using ASHP and NCDC guidelines for prevention of SSIs. Material and Methods: Between 1st March 2018 to 31st August 2019 data was collected prospectively in case record form (CRF) after getting approval from institutional ethics committee. Total 1019 CRFs were recorded and analysed for adherence to SAP criterion given in ASHP and NCDC guidelines. Results: Out of 1019 cases, 489 were males (47.99%) and 530 cases were females (52.01%). Most common surgical wounds encountered were clean (47.50%), and clean-contaminated (46.61%) to which guidelines are applied. Except for one patient (0.1%) almost all patients received AMAs for the period of two day or more. Considering timing of administration, in around 25.02% cases AMA was administered within 60 minutes of surgical incision whereas in 74.98% AMA was administered before 60 minutes of surgical incision. Conclusion: The present research demonstrated that the use of surgical antimicrobial prophylaxis (SAP) was not in accordance with national and international guidelines.

Keywords: Surgical wound infection, guideline adherence, Anti-Bacterial Agents, Antibiotic Prophylaxis.