Antibiotic Prescription Practices for Surgical Prophylaxis in India: An Observational Study

Sanu Anand Cloudphysician Healthcare, Bangalore, India;

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Dileep Raman Cloudphysician Healthcare, Bangalore, India;

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Divya Shetty Apollo Hospitals, Bangalore, India

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Dhruv Joshi Cloudphysician Healthcare, Bangalore, India;

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C. G. Hamsaveni Cloudphysician Healthcare, Bangalore, India;

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Dileep C. Unnikrishnan Cloudphysician Healthcare, Bangalore, India;

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DOI:
https://doi.org/10.4269/ajtmh.19-0267
Volume/Issue:
Volume 101: Issue 4
Page(s):
919–922
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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.

Author Notes

Address correspondence to Dileep C. Unnikrishnan, Cloudphysician Healthcare, 7 Bellary Rd., Ganganagar, Bangalore, India. E-mail: drdileepunni@gmail.com

Authors’ addresses: Sanu Anand, Dileep Raman, Dhruv Joshi, C. G. Hamsaveni, and Dileep C. Unnikrishnan, Cloudphysician Healthcare, Bangalore, India, E-mails: sanu.anand@cloudphysician.net, dileep.raman@cloudphysician.net, dhruv.joshi@cloudphysician.net, hamsaveni.cg@cloudphysician.net, and dileep.unni@cloudphysician.net. Divya Shetty, Apollo Hospitals, Bangalore, India, E-mail: divya.shetty@cloudphysician.net.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2019
Received:
08 Apr 2019
|
Accepted:
19 Jul 2019
|
Published Online:
12 Aug 2019
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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