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. 2013 Dec;7(12):2747-51.
doi: 10.7860/JCDR/2013/6409.3751. Epub 2013 Dec 15.

Prophylactic antibiotics and wound infection

Abubaker Ibrahim Elbur  1 , Yousif M A  2 , Ahmed S A El-Sayed  3 , Manar E Abdel-Rahman  4
Affiliations

Prophylactic antibiotics and wound infection

Abubaker Ibrahim Elbur et al. J Clin Diagn Res. 2013 Dec.

Abstract

Introduction: Surgical site infections account for 14%-25% of all nosocomial infections. The main aims of this study were to audit the use of prophylactic antibiotic, to quantify the rate of post-operative wound infection, and to identify risk factors for its occurrence in general surgery.

Methodology: A cross-sectional study was conducted in the General Surgery Department in Khartoum Teaching Hospital- Sudan. All Adult patients (age ≥18 years) admitted during March 1(st) to 31(st) October 2010 were recruited. Multivariable logistic analysis was done to identify wound infection risk factors. Prescriptions were audited against predetermined criteria.

Results: A total of 540 patients were recruited; (females73.7% of total ). The performed surgical procedures were 547. The rate of wound infection was 10.9%. Multivariable logistic analysis showed that; ASA score ≥ 3; (p= <0.001), wound class (p= 0.001), and laparoscopic surgical technique; (p= 0.002) were significantly associated with prevalence of wound infection. Surgical prophylaxis was unnecessarily given to 311 (97.5%) of 319 patients for whom it was not recommended. Prophylaxis was recommended for 221 patients; of them 218 (98.6 %) were given preoperative dose in the operating rooms. Evaluation of prescriptions for those patients showed that; spectrum of antibiotic was adequate for 160 (73.4%) patients, 143 (65.6%) were given accurate doses, only 4 (1.8%) had the first preoperative dose/s in proper time window, and for 186 (85.3%) of them prophylaxis was extended post-operatively. Only 36 (6.7%) prescriptions were found to be complying with the stated criteria.

Conclusion: The rate of wound infection was high and prophylactic antibiotics were irrationally used. Multiple interventions are needed to correct the situation.

Keywords: Prophylactic antibiotics; Sudan; Wound infection.

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