1921
Volume 101, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Perioperative prophylactic antibiotics following surgeries have been shown to reduce surgical site infections, and their administration is common practice. Despite clear guidelines regarding this being set forth by the Infectious Disease Society of America (IDSA), adherence to them is yet to translate to common practice in many parts of the world. A retrospective chart review of 409 patients who underwent elective surgeries over a period of 7 months at three different hospitals in India was performed. In-hospital antibiotic prescriptions of these patients were examined for any apparent inappropriateness (use of antibiotics with coverage broader than the target microbes and use of antibiotics with overlapping spectrum of target microbes). Four hundred ninety-five (48.9%) of the 1,012 patient intensive care unit (ICU) days had apparent inappropriateness in the choice of their prophylactic antibiotics and only 3.2% of the antibiotic units used were in accordance with the present IDSA guidelines. Injudicious use of broad-spectrum antibiotics for surgical prophylaxis is prevalent in low- and middle-income countries such as India. This poses the risk of emergence of resistant microorganisms in these areas and their potential spread across the borders. There is an acute need for diligent antibiotic stewardship programs in these areas to curb such practices.

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References

  1. Sjoding MW, Prescott HC, Wunsch H, Iwashyna TJ, Cooke CR, 2016. Longitudinal changes in ICU admissions among elderly patients in the United States. Crit Care Med 44: 13531360.
    [Google Scholar]
  2. Dixit A, Kumar N, Kumar S, Trigun V, 2019. Antimicrobial resistance: Progress in the decade since emergence of New Delhi metallo-β-lactamase in India. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine 44: 4.
    [Google Scholar]
  3. Van Boeckel TP, Gandra S, Ashok A, Caudron Q, Grenfell BT, Levin SA, Laxminarayan R, 2014 Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis 14: 742750.
    [Google Scholar]
  4. Bratzler DW et al., 2013 Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect 14: 73156.
    [Google Scholar]
  5. Gupta E, Mohanty S, Sood S, Dhawan B, Das BK, Kapil A, 2006. Emerging resistance to carbapenems in a tertiary care hospital in north India. Indian J Med Res 124: 9598.
    [Google Scholar]
  6. MacKenzie FM, Gould IM, 2005. Quantitative measurement of antibiotic use. Gould IM, van der Meer JWM, eds. Antibiotic Policies: Theory and Practice. Boston, MA: Springer US, 105118.
    [Google Scholar]
  7. Bowater RJ, Stirling SA, Lilford RJ, 2009. Is antibiotic prophylaxis in surgery a generally effective intervention?: testing a generic hypothesis over a set of meta-analyses. Ann Surg 249: 551.
    [Google Scholar]
  8. Allegranzi B et al., 2016 New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis 16: e288e303.
    [Google Scholar]
  9. Berríos-Torres SI et al., 2017 Centers for disease control and prevention guideline for the prevention of surgical site infection. JAMA Surg 152: 784791.
    [Google Scholar]
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  • Received : 08 Apr 2019
  • Accepted : 19 Jul 2019
  • Published online : 12 Aug 2019
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