A Critical Evaluation and Comparison of Antimicrobial Prophylaxis in Elective Surgeries Across three Hospitals
Published: June 1, 2013 | DOI: https://doi.org/10.7860/JCDR/2013/.3063
Yogesh Belagali, Alwar MC,Poornachandra Thejeswi,Ullal Sheetal D
Vani Bhagwath,Ashok Shenoy K,Mukta Chowta,Dr.Sahana D Acharya
1. Post Graduate Student, Department of Pharmacology,
Kasturba Medical College, Mangalore, Manipal University
India.
2. Professor, Department of Pharmacology, Kasturba Medical
College, Mangalore, Manipal University India.
3. Associate Professor, Department of Surgery, Kasturba
Medical College, Mangalore, Manipal University India.
4. Associate Professor, Department of Pharmacology,
Kasturba Medical College, Mangalore, Manipal University
India.
5. Post Graduate Student, Department of Pharmacology,
Kasturba Medical College, Mangalore, Manipal University
India.
6. Professor and Head, Department of Pharmacology,
Kasturba Medical College, Mangalore, Manipal University
India.
7. Additional Professor, Department of Pharmacology,
Kasturba Medical College, Mangalore, Manipal University
India.
8. Associate Professor, Department of Pharmacology,
Kasturba Medical College, Mangalore, Manipal University
India.
Correspondence
Dr. Ullal Sheetal D,
Associate Professor, Department of Pharmacology,
Kasturba Medical College, Light House Hill Road,
Mangalore- 575001, India.
Phone: +91 9448306242
E-mail: sheetal.ullal@manipal.edu
Objectives: 1. To evaluate and compare the pattern and rationality of prophylactic antimicrobial therapy in elective surgeries. 2. To evaluate and compare the adherence of hospitals to the standard guidelines on prophylactic antimicrobial therapy.
Methodology: A total of 150 patients each from a government hospital (group I), medical college teaching hospital (group II), and corporate hospital attached to the institution (group III) who had undergone elective, non-complicated surgery were included. The number & types of antimicrobials used along with duration were noted. Rationality was assessed on the basis of Kunin’s criteria, ASHP guidelines & SIGN guidelines. Statistical analysis was done using appropriate tests.
Results: Cephalosporins were the most commonly used antimicrobials in all three groups (52.6%,85.7% & 84.8% respectively) followed by nitroimidazoles. Antimicrobial prophylaxis was appropriate in only 14.1%, 23.3% & 32.9% cases in the three groups respectively (p<0.01).The most common problem was prolonged duration of administration in 50.3%,58% & 45% respectively. The implementation of prophylaxis with respect to regimen & duration was erroneous in 20.1%, 12.7% & 4.7% respectively (p<0.01).
Conclusion: The rationality & regimen of antimicrobial prophylaxis was comparatively better in the corporate hospital followed by medical college hospital and the government hospital. The present study calls for an urgent review on rational use of antimicrobials for prophylaxis in all the 3 hospitals.
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