Biomedicine

Abstract

Introduction and Aim: Surgical site infections (SSI) are the second most common hospital acquired infection, which extends the hospitalization, increases the surgical expenditure and morbidity. However, antibiotics have saved millions of lives, it is inappropriate and indiscriminate use initiated antimicrobial resistance. A bundle care intervention with appropriate Surgical Antimicrobial Prophylaxis (SAP) selection, adequate pre-operation preparation, and post-operative care will reduce the incidence of SSI. As surgical antimicrobial prophylaxis guidelines policy is one of the core front-end strategies in antimicrobial stewardship, we aimed to restrict the use of various surgical antimicrobials, to implement the new policy guidelines, to monitor its usage, and to compare the rate of SSI before and after its implementation.
Methodology: An interventional comparative study, done in a multispecialty hospital, includes all clean and clean-contaminated surgeries done from June 2015 to December 2017. With adequate education, strict usage of Inj. cefazolin/cefuroxime as SAP was implemented and the rate of SSI was calculated and compared between the two phases.
Results: The rate of SSI in phase 1 was 0.59 and in phase 2 was 0.58 SSI per 100 surgeries. Use of Inj. cefazolin/cefuroxime as prophylaxis in all clean and clean-contaminated surgeries ranged between 70-80% followed by 100% in subsequent months. E. coli was the commonest pathogen isolated in both phases.
Conclusion: Though cefazolin/cefuroxime usage has not created a change in the SSI rate, it created a wide range of awareness and attitude change among all to prescribe. Thus, this study might add a significant role in preventing the emerged antimicrobial resistance in the future.