CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci
DOI: 10.1055/s-0041-1728972
Original Article

Surgical Antimicrobial Prophylaxis—Where Do We Stand?

Anuja Jha
1  Department of Pharmacology, Sri Aurobindo Medical College and P.G. Institute, Indore, Madhya Pradesh, India
,
Manju Agrawal
2  Department of Pharmacology, Pt. Jawahar Lal Nehru Memorial Medical College, Raipur, Chhattisgarh, India
,
Rajesh Hishikar
3  Department of Pharmacology, Ayush and Health Sciences, University of Chhattisgarh, Raipur, Chhattisgarh, India
,
Himanshu Shekhar Jha
4  Department of Petroleum Engineering, Texas A&M University, Texas, United States
› Author Affiliations

Abstract

Introduction Surgical site infection (SSI) is the commonest preventable health care–associated infection among postoperative cases. Several guidelines are available for surgical antimicrobial prophylaxis (SAP) and other measures which prevent SSI. National Center for Disease Control (NCDC), India, has also provided a guideline for prevention of SSI in 2016. In this study we have compared the NCDC, India, guideline with WHO (World health organization) and American Society of Health System Pharmacists (ASHP) guidelines. The timing of antimicrobial agent administration is the only parameter which is included in all the three guidelines. As per NCDC and ASHP it should be within 60 minutes of incision while as per WHO it is within 120 minutes of incision.

Material and Methods  This was a prospective observational study—104 patients undergoing surgery in general surgical ward between January 2016 and June 2017 were included in this study. The NCDC guideline was compared with WHO and ASHP guidelines. Real data comparison was done for those parameters which were included in all the three guidelines.

Statistical Analysis Data were analyzed using descriptive methods and chi-square test.

Results None of the patients in our study received SAP within 60 minutes of incision. In 70% cases it was administered within 2 hours of incision and in the remaining 30% it was administered after more than 2 hours. There was no significant difference in the incidence of SSI among these two groups.

Conclusion NCDC SAP guideline helps in rational use of antimicrobials. Increasing the duration for SAP may be added in the NCDC guidelines. Inclusion of certain additional parameters like weight-based doses and consideration for other comorbidities will help in patient- and procedure-specific SAP. Antimicrobial stewardship should be encouraged in all the hospitals and should follow local antimicrobial resistance pattern. This will assist in therapy decision, policy making, and evidence-based treatment.



Publication History

Publication Date:
11 May 2021 (online)

© 2021. National Academy of Medical Sciences (India). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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