Antibiotic in general surgery: selection, timing and duration of administration

A continuous surveillance of hospital acquired infection (HAI) was done in the Department of Surgery, Dhaka Medical College Hospital during the period of 1st February '90 to 31st March '90. A new antibiogramme was prepared and applied in the same unit for chemotherapy and chemoprophylaxis of surgical cases in the subsequent six months from April '90 to September '90. The result of this selection, timing of administration and the duration of antimicrobial use have been described in this report. The antibiotic policy adopted in this study has been found to improve the problem of infection in our surgical practice substantially. The incidence of HAI has been reduced to 0.5% from 3.9% which was seen in our previous study. The median post operative hospital stay has been reduced to 15.5 days from 18.5 days in case with HAI and to 8.5 days from 9 days without HAI. We conclude that a continuous surveillance of hospital acquired infection is necessary to develop an appropriate antibiogramme. The appropriate antibiotic should be started at the induction of anaesthesia and may be a part of the induction procedure.