Utilization Assessment of Surgical Antibiotic Prophylaxis at Ayder Referral Hospital, Northern Ethiopia

Introduction: Surgical site infection represents a significant burden in terms of patients’ morbidity, mortality and hospital costs which can be prevented using prophylaxis. Objective: To assess rate of compliance to Surgical Antibiotic Prophylaxis (SAP) guidelines at Ayder Referral Hospital (ARH). Method: Prospective cross-sectional study was conducted from 12th March to 28thApril, 2015. Data were collected using data abstraction checklist for all patients who underwent surgery and met inclusion criteria. SAP Guidelines and CDC Wound Classification were used as data assessment protocols. Epidata 3.1 and SPSS 16 were used for data entry and analysis of descriptive statistics. Results: A total of 196 patients with mean age of 37.84 years were recruited (female, 58.7%). Of these, 62.2% received SAP but prophylaxis was needed in 58.2%. The total compliance to SAP guideline was 21.9% and 25% for national Standard Treatment Guideline (STG) and American Society of Health-system Pharmacist (ASHP) guideline respectively. Selection of SAP (national STG 100% versus ASHP Guideline 89.5%) was the most deviated parameter from SAP guidelines followed by duration (63.5%), indication (19.4%) and dose (10.4%). Most commonly used agent was ceftriaxone (85.2%). Conclusion: Current practice of ARH is hugely divergent from SAP guidelines. Use of broader spectrum antibiotics for an extended period was common.