Use of antibiotics in surgical setup in tertiary healthcare hospital

Kanishka Goswami, Satish Kumar, S. Solanki, Jyoti Rana
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Abstract

Surgical antimicrobial prophylaxis refers to brief course of an antimicrobial agent which is initiated just before surgery, to prevent any infections at the surgical site. It is one of the most widely accepted practices in surgery. However, despite the evidence of the effectiveness and the publication of guidelines for the antimicrobial prophylaxis, its use is often found to be suboptimal. However, between 30-90% of this prophylaxis is inappropriate.Hence, this study was planned in order to examine the prevalent practices in the tertiary care hospital regarding the use of antimicrobials for surgical prophylaxis, with respect to the choice of the antimicrobial agent, the timing of its administration, the intraoperative reposing and the total duration of the prophylaxis, in order to detect any inappropriateness, so that corrective measures could be suggested.A survey was conducted across the various departments undergoing surgery of 213 patients and was followed till their discharge. The age of patients varied from 5 to 85 years. Following risk factors were also included like anemia, smoking, alcohol, prolonged duration of surgery. All the cases in our study received prophylactic antimicrobials prior to surgery, even though prophylactic systemic antimicrobials are not typically indicated for the patients who underwent clean surgical site operations.Though, this aspect was also the basis of forming two groups viz. group A and group B; this mode of treatment prior to surgery was found effective. Males are more prone to treatment failure, as suggested by the study. While recovery in females with the preliminary line of treatment continues in a positive way. A 75 cases out of 213 undergoing surgeries which are given planned regimes of antibiotic prophylaxis still end up with surgical site infection which is many a times not notified. To overcome this, change in antimicrobial regime is employed.
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三级医院外科设置中抗生素的使用
外科抗菌预防是指在手术前开始使用抗菌药物的短暂疗程,以防止手术部位的任何感染。这是外科手术中最被广泛接受的做法之一。然而,尽管有证据表明其有效性和抗菌预防指南的出版,其使用往往被发现是次优的。然而,30-90%的预防措施是不适当的。因此,计划进行这项研究是为了检查三级护理医院在外科预防中使用抗菌剂的普遍做法,包括抗菌剂的选择、给药时间、术中休息和预防的总持续时间,以便发现任何不适当的情况,以便提出纠正措施。对213名接受手术的患者在不同科室进行了调查,并随访至出院。患者年龄从5岁到85岁不等。以下风险因素还包括贫血、吸烟、饮酒、手术时间延长。我们研究中的所有病例在手术前都接受了预防性抗菌素治疗,尽管预防性全身抗菌素治疗通常不适用于接受清洁手术部位手术的患者。然而,这方面也是形成A组和B组的基础;手术前的这种治疗方式被认为是有效的。研究表明,男性更容易治疗失败。而女性在接受初步治疗后的恢复仍在积极进行。213例接受手术的患者中有75例接受了有计划的抗生素预防治疗,但最终还是发生了手术部位感染,很多时候都没有通知。为了克服这一点,采用了改变抗微生物方案。
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