Prophylactic antibiotics and wound infection

Area of Science:

• Infectious Diseases
• Surgical Outcomes
• Antibiotic Stewardship

Background:

• Surgical site infections (SSIs) represent a significant portion of hospital-acquired infections, ranging from 14% to 25%.
• General surgery settings experience substantial rates of post-operative wound infections.
• Effective use of prophylactic antibiotics is crucial for preventing SSIs.

Purpose of the Study:

• To audit the current practices of prophylactic antibiotic administration in general surgery.
• To determine the incidence of post-operative wound infections.
• To identify key risk factors associated with the development of wound infections.

Main Methods:

• A cross-sectional study was conducted at Khartoum Teaching Hospital's General Surgery Department.
• Adult patients (≥18 years) admitted during March-October 2010 were included.
• Multivariable logistic analysis was employed to identify risk factors, and antibiotic prescriptions were audited against set criteria.

Main Results:

• A wound infection rate of 10.9% was observed among 540 recruited patients.
• Higher American Society of Anesthesiologists (ASA) score (≥3), wound class, and laparoscopic techniques were significant risk factors for infection (p<0.001, p=0.001, p=0.002 respectively).
• Prophylactic antibiotics were inappropriately prescribed in 97.5% of cases, with significant deviations in timing, spectrum, dosage, and duration, leading to only 6.7% compliance with guidelines.

Conclusions:

• The study revealed a high incidence of surgical site infections.
• Prophylactic antibiotic utilization was found to be irrational and non-compliant with established guidelines.
• Urgent interventions are necessary to optimize antibiotic prescribing and reduce infection rates.