Volume 24, Issue 3 (Iranian South Medical Journal 2021)
Iran South Med J 2021, 24(3): 188-196 |
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Rastegar R, Rahimi F, Vahdat K, Motamed N, Bahrami M. Prophylactic Antibiotic Administration for Operations in a Teaching Hospital in Bushehr, Iran. Iran South Med J 2021; 24 (3) :188-196
URL: http://ismj.bpums.ac.ir/article-1-1475-en.html
URL: http://ismj.bpums.ac.ir/article-1-1475-en.html
1- Department of Infectious Diseases, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran , r_rastegar64@yahoo.com
2- Student Research Committee, School of Internal Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
3- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
4- Department of community Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
2- Student Research Committee, School of Internal Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
3- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
4- Department of community Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
Abstract: (2186 Views)
Background: One of the most effective modalities for reducing surgical site infection is the use of prophylactic antibiotics, but the inappropriate consumption of antibiotics before operations leads to an increased prevalence of resistant bacterial infections, adverse drug side-effects and financial burden. This study examined the logical administration of prophylactic antibiotics and its patient outcomes and compared the results with international guidelines.
Materials and Methods: In this study, 348 patients who were elective surgery candidates were assessed over six months. The patients’ demographic information, type of operation, and antibiotic indication, type, dosage, and time and duration of administration before the operation were entered into a checklist and the results were compared against the American Society of Health system Pharmacists (ASHP) guidelines.
Results: The indication for prophylactic antibiotics was correct in 88.5% of the 348 patients examined. In those with prophylactic antibiotic indication, the antibiotic type used before surgery was appropriate in 73 (83.9%) out of 87 cases. The antibiotic dosage before the surgery was correct in 72 (98.6%) patients. The timing of antibiotic administration was correct in 36 (49.4%) cases. The duration of antibiotic administration was in accordance with the standard guidelines in 53 patients (27.7%).
Conclusion: In this study, the lowest accordance with standard guidelines was observed in the duration of prophylactic antibiotic intake. Considering the side effects of antibiotic overuse and its financial burden, developing a unique standard guideline, providing training to the prescribers of medications to adhere to this guideline, and the careful tracking and receiving of feedback seem desirable solutions to overcome this challenge.
Materials and Methods: In this study, 348 patients who were elective surgery candidates were assessed over six months. The patients’ demographic information, type of operation, and antibiotic indication, type, dosage, and time and duration of administration before the operation were entered into a checklist and the results were compared against the American Society of Health system Pharmacists (ASHP) guidelines.
Results: The indication for prophylactic antibiotics was correct in 88.5% of the 348 patients examined. In those with prophylactic antibiotic indication, the antibiotic type used before surgery was appropriate in 73 (83.9%) out of 87 cases. The antibiotic dosage before the surgery was correct in 72 (98.6%) patients. The timing of antibiotic administration was correct in 36 (49.4%) cases. The duration of antibiotic administration was in accordance with the standard guidelines in 53 patients (27.7%).
Conclusion: In this study, the lowest accordance with standard guidelines was observed in the duration of prophylactic antibiotic intake. Considering the side effects of antibiotic overuse and its financial burden, developing a unique standard guideline, providing training to the prescribers of medications to adhere to this guideline, and the careful tracking and receiving of feedback seem desirable solutions to overcome this challenge.
Type of Study: Original |
Subject:
Surgery
Received: 2021/03/7 | Accepted: 2021/06/19 | Published: 2021/09/1
Received: 2021/03/7 | Accepted: 2021/06/19 | Published: 2021/09/1
References
1. Montazeri M, Shayeste SH, Haddadi A Survey of Antibiotic Prophylaxis Administered Before Surgery in a Teaching Hospital in Tehran 2014. Iran J Infect Dis Trop Med 2017; 21(75): 37-42. (Persian)
2. Rafiei N, Aghapour SM, Koochaki F, et al. Impact Of The Educational Intervention On Adherence To Guidelines For Antibiotic Prophylaxis Before Surgeries. J North Khorasan Univ Med Sci 2014; 6(3): 467-76. (Persian)
3. Afhami Sh, Esmailpour Bazaz N, Boujar Arani N, et al. Antibiotic Prophylaxis Before Surgeries. Iran J Surg 2011; 19(3): 1-8. (Persian)
4. Shabanian A, Karimi Nasab MH, Shayesteh Azar M, et al. Type And Rate Of Prophylactic Antibiotic Use In The Orthopedic Patients Underwent Elective Surgeries In Shahid Beheshti Hospital In Babol. J Babol Univ Med Sci 2018; 20(5): 68-73.
5. Kremer KM, Foster RT, Drobnis EZ, et al. Non-Indicated Use Of Prophylactic Antibiotics In Gynaecological Surgery At An Academic Tertiary Medical Centre. J Obstet Gynaecol 2018; 38(4): 543-7.
6. Akbari H, Elyasi L, Akbari R, et al. Evaluation Of Prophylactic Antibiotics In Surgery Compared To The National Antibiotic Guideline. J Sabzevar Univ Med Sci 2016; 22(6): 1071-79. (Persian)
7. Tefera GM, Feyisa BB, Taye GM, et al. The Association Between Incorrect Use Of Antibiotic Prophylaxis And In-Hospital Surgical Site Infections – A Prospective Observational Study. Infect Drug Resist 2020; 13: 3063-72.
8. Lerano C, Thurskey K, Marshall C, et al. Appropriateness Of Surgical Antimicrobial Prophylaxis Practices In Australia. JAMA Netw Open 2019; 2(11): e1915003.
9. Karaali C, Emiroglu M, Çalik B, et al. Evaluation Of Antibiotic Prophylaxis And Discharge Prescriptions In The General Surgery Department. Cureus 2019; 11(6): e4793.
10. Askarian M, Moravveji AR, Assadian O. Prescription Of Prophylactic Antibiotics For Neurosurgical Procedures In Teaching Hospitals In Iran. Am J Infect Control 2007; 35(4): 260-2.
11. Alavi SM, Roozbeh F, Behmanesh F, et al. Antibiotics Use Patterns For Surgical Prophylaxis Site Infection In Different Surgical Wards Of A Teaching Hospital In Ahvaz, Iran. Jundishapur J Microbiol 2014; 7(11): e12251.
12. Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical Practice Guidelines For Antimicrobial Prophylaxis In Surgery. Am J Health Syst Pharm 2013; 70(3): 195-283.
13. Khatami-Moghadam M, Khorsandi-Ashtiani MT, Mohagheghi MA, et al. Prophylactic Antibiotics In Otolaryngologic Surgeries: From Knowledge To Practice. Iran J Otorhinolaryngol 2012; 24(67): 79-84.
14. Ayele Y, Taye H. Antibiotic Utilization Pattern For Surgical Site Infection Prophylaxis At Dil Chora Referral Hospital Surgical Ward, Dire Dawa, Eastern Ethiopia. BMC Res Notes 2018; 11: 537.
15. Alemkere G. Antibiotic Usage In Surgical Prophylaxis: A Prospective Observational Study In The Surgical Ward Of Nekemte Referral Hospital. PLoS One 2018; 13(9): e0203523.
16. Safrgholi SH, Mosavi F, Foghani Y, et al. Adherence To International And National Prophylaxis Guidelines In Surgical Wards Of Boali Hospital In Tehran In 1390. Iran J Infect Dis Trop Med 2013; 17(59): 23-7. (Persian)
17. Misganaw D, Linger B, Abesha A. Surgical Antibiotic Prophylaxis Use And Surgical Site Infection Pattern In Dessie Referral Hospital, Dessie, Northeast Of Ethiopia. Biomed Res Int 2020; Article ID 1695683.
18. Yousefi P, Monajati M, Salehifar E. Evaluation Of Prophylactic Antibiotic Administration In General Surgery Division Of A Teaching Hospital In North Of Iran. Pharm Biomed Res 2016; 2(4): 30-7.
19. Al-Momany NH, Al-Bakri AG, Makahleh ZM, et al. Adherence To International Antimicrobial Prophylaxis Guidelines In Cardiac Surgery: A Jordanian Study Demonstrates Need For Quality Improvement. J Manag Care Pharm 2009; 15(3): 262-71.
20. Moges G, Belete L, Mengesha Y, et al. Evaluation Of Surgical Antimicrobial Prophylaxis And Incidence Of Surgical Site Infection At Borumeda Hospital, Northeast Ethiopia: Retrospective Cross-Sectional Study. Drug Healthc Patient Saf 2020; 12: 257-68.
21. Ministry Of Health And Medical Education. Managed care. Prophylactic Antibiotic Before Surgery. Eighth Management Surveillance Announcement Of Ministry Of Health And Medical Education. (Available from: URL: https://treatment.sbmu.ac.ir/uploads/0013- managed_care.pdf)
22. Karaali C, Emiroglu M, Esin H, et al. Assessment Of Prophylactic Antibiotic Usage Habits Of The General Surgeons In Turkey. J Infect Dev Countr 2020; 14(7): 758-64.
23. Rehan HS, Kumar Kakkar A, Goel SH. Pattern Of Surgical Antibiotic Prophylaxis In A Tertiary Care Teaching Hospital In India. Int J Infect Contr 2010; 6(2): 1-6.
24. Talebi Lak H, Maghsoudi H, Zarrintan S, et al. Evaluation Of The Prevalence And Pattern Of Antibiotic Prescription For Preventing Infection After General Surgery Compared With The Standard Guidelines. Stud Med Sci 2020; 30(12): 960-8.
25. Yasaman M, Moazen L. Effect Of Education Of Local Guideline For Prophylactic Antibiotic Before Surgery On Following Antibiotic Prophylaxis Prescription In Kerman Payambar Aazam Hospital 2016. 8th Congress Of Infection Control And Medical Equipment. 2018 Aug, 30-31, Tehran, Iran. Kerman: Payam Nor Univ, 2018.
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