Surgical Antibiotic Prophylaxis Used in A University Clinics Hospital and Antibiotic Costs: A 3-year Survey

Surgical Site Infections (SSIs) represent one of the most common post-operative complications and are the third most prevalent nosocomial infections.

The objective of this study was to analyze the conditions of using antibiotics in surgery at the University Clinics of Lubumbashi.

A retrospective study was conducted, collecting data from medical registers over a 3-year period, from 2017 to 2019. Parameters have been analyzed according to the European Centre for Disease Prevention and Control (ECDC), National Institute for Health and Care Excellence (NICE) and World Health Organization (WHO) guidelines.

Shortcomings in registered data and the application of exclusion criteria allowed to include only 256 of the 977 retrospective procedures recorded during this period, with around 50% of the cases in 2019. A little more than half of them concerned men with a sex ratio of 1.28. Among these patients, 66% were aged between 16 and 40 years. Of these, 37.1% underwent visceral surgery. Over 38.7% of patients were hospitalized for more than 30 days, with 4.3% staying over 4 months. After the surgery, metronidazole 1.5 g, ceftriaxone 1 g and cefotaxime 1 g were the most used (89%) antibiotics followed by amoxicillin 1 g, all mainly parenterally. In 38,7% of cases, a series of other antibiotics were used in combination over a long period (7 days). A 32.8% rate of surgical site infection was recorded, with antibiotic-related costs of around 62,311 ± 30,417 CDF (31 ± 15 €). A comparison of the characteristics of patients with and without infections showed a significant influence of the sex and type of surgery. Men were 4.7 times more likely to develop a surgical site infection than women, and orthopedic surgery had a higher risk of infection than other surgeries.

These retrospective data suggest that the use of antibiotics before and after surgery at the University Clinics of Lubumbashi does not meet accepted standards (ECDC, NICE and WHO guidelines) and would not be efficient for their intended purpose.