EVALUATION OF ANTIMICROBIAL PROPHYLAXIS USAGE IN THE SURGICAL PROCEDURES

Abstract

Surgical site infections (SSIs) are the most common postoperative complications and represent a significant burden in
terms of patient morbidity, mortality, and health costs. Choice of regimen, time of administration, and duration of antibiotic prophylaxis were inappropriate in 25-50% of cases from previous studies. Therefore, the main aim is to evaluate the
appropriateness of antimicrobial prophylaxis use in surgery at the Misurata Central Hospital (MCH). The study included
247 surgical inpatients of any age, who were admitted and discharged from surgical departments: gyneocology and obstetrics, orthopedics, and general surgery in the Misurata Central Hospital (MCH) over a period of six months from (1st January to 30th June 2016). The total of 247 patients underwent surgery and administered antimicrobial prophylaxis in the perioperative period. Appropriateness of antimicrobial prophylaxis was evaluated according to published guidelines of the
American Society of Health-System Pharmacists (ASHP) for every aspect of antibiotic prophylaxis. All data were coded
and analyzed using statistical software (Stat View version 5.1). The study showed 94.3% of prescribed and administered
prophylactic antibiotics were in accordance with the American Society of Health-System Pharmacists (ASHP) guidelines
regarding prophylaxis indication. The total compliance for the studied parameters was (3.2%), only (10.5%) had appropriate antibiotic selection, and (50.6%) of patients received antibiotic in appropriate duration. The general surgery department
had higher total adherence to the ASHP guidelines (P=0.006). The gyneocology department had much compliance regarding duration of antibiotic use (P = 0.00001); however, general surgery had higher proper antibiotic selection (P = 0.0001).
A lack of concordance between the use of antimicrobial prophylaxis and prescribing guidelines was identified in this study
at the MCH.