Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov 18;55(3):749-757.
doi: 10.1007/s43465-020-00306-0. eCollection 2021 Jun.

Current Surgical Antibiotic Prophylaxis Practices: A Survey of Orthopaedic Surgeons in India

John Ashutosh Santoshi  1 , Prateek Behera  1 , Manoj Nagar  2 , Ramesh Sen  3 , Anirban Chatterjee  4
Affiliations

Current Surgical Antibiotic Prophylaxis Practices: A Survey of Orthopaedic Surgeons in India

John Ashutosh Santoshi et al. Indian J Orthop. .

Abstract

Background: Surgical antibiotic prophylaxis (SAP) has become the standard of care in orthopaedic surgery. Inappropriate usage of antibiotics (dosage, strength, and/or administration time and duration) can inadvertently result in superadded infections and antimicrobial resistance. The purpose of this study was to document and analyse the prescription patterns for SAP, and to investigate the factors associated with divergence from standard guidelines.

Methods: We conducted an online cross-sectional questionnaire-based study to collect information about the SAP practices of the members of the Indian Orthopaedic Association (IOA) using Google forms. A link to the questionnaire was sent by e-mails.

Results: The overall response rate was 5.73%. While 97.3% respondents practised SAP routinely, the practice was not aligned with standard guidelines' recommendations. There was heterogeneity in the use of SAP in terms of choice of antibiotic(s), number of co-prescribed drugs, single- versus multiple-dose regimens, and the duration of therapy. The prescription practice patterns showed that orthopaedic surgeons almost always used broad-spectrum antibiotics for long durations, regardless of the type of surgery.

Conclusion: While Orthopaedic surgeons in India are practicing SAP, the pattern of antibiotic usage is heterogeneous. Variations were noted in the choice of antibiotics for different types of surgeries, time of administration, duration of usage in the postoperative period as well as co-prescriptions. This study highlights the urgent need for a comprehensive, rational, and robust national SAP policy for orthopaedic surgeries.

Keywords: Antibiotic; Elective surgery; Orthopaedic association; Perioperative antibiotic prophylaxis; Prescription practice; Surgical antibiotic prophylaxis; Surgical site infection; Trauma surgery.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Summary of the details of email requests sent and the responses included for final analysis
Fig. 2
Fig. 2
Depicting the concordance of responses with the National centre for disease control (NCDC) guidelines
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Yeap JS, Lim JW, Vergis M, Au Yeung PS, Chiu CK, Singh H. Prophylactic antibiotics in orthopaedic surgery: guidelines and practice. Medical Journal of Malaysia. 2006;61(2):181–188. - PubMed
    1. Mathur P, Trikha V, Farooque K, Sharma V, Jain N, Bhardwaj N, et al. Implementation of a short course of prophylactic antibiotic treatment for prevention of postoperative infections in clean orthopaedic surgeries. Indian Journal of Medical Research. 2013;137(1):111–116. - PMC - PubMed
    1. Hawn MT, Knowlton LM. Balancing the risks and benefits of surgical prophylaxis: timing and duration do matter. JAMA Surgery. 2019;154(7):598–599. doi: 10.1001/jamasurg.2019.0570. - DOI - PubMed
    1. Sewell M, Adebibe M, Jayakumar P, Jowett C, Kong K, Vemulapalli K, et al. Use of the WHO surgical safety checklist in trauma and orthopaedic patients. International Orthopaedics. 2011;35(6):897–901. doi: 10.1007/s00264-010-1112-7. - DOI - PMC - PubMed
    1. Argaw NA, Shumbash KZ, Asfaw AA, Hawaze S. Assessment of surgical antimicrobial prophylaxis in Orthopaedics and Traumatology Surgical Unit of a Tertiary Care Teaching Hospital in Addis Ababa. BMC Research Notes. 2017;10(1):160. doi: 10.1186/s13104-017-2475-2. - DOI - PMC - PubMed

LinkOut - more resources