Antimicrobial prophylactic practice in surgical patients

Area of Science:

• Surgical Infection Prevention
• Antimicrobial Stewardship
• Healthcare Quality Improvement

Background:

• Pre-operative antimicrobial prophylaxis is crucial for preventing surgical site infections.
• Current prescribing patterns for surgical antimicrobial prophylaxis require evaluation.

Purpose of the Study:

• To assess the prescribing practices of surgeons regarding pre-operative antimicrobial prophylaxis.
• To identify areas for improvement in antimicrobial use in surgical settings.

Main Methods:

• Retrospective analysis of surgical patient case records.
• Inclusion of 888 patients receiving antibiotic therapy (prophylaxis or treatment).
• Data collected from the Department of Surgery, Royal Commission Medical Center.

Main Results:

• Antibiotics were prescribed for prophylaxis in 21.5% and for therapy in 78.5% of patients.
• Ceftriaxone was the most common prophylactic agent, often administered in multiple doses exceeding 24 hours.
• Unwarranted use of prophylactic agents was observed in at least 70% of cases, leading to increased hospital costs.

Conclusions:

• Significant overuse of prophylactic antimicrobial agents was identified.
• Effective prophylaxis can be achieved with single-dose cephalosporins (e.g., ceftriaxone, cefuroxime, cefazolin).
• Implementation of guidelines, standing orders, and audits is recommended to improve compliance with antimicrobial prophylaxis principles.