Surgical antimicrobial prophylaxis, when used appropriately, plays a crucial role in lowering Surgical Site Infection (SSI) occurrences, especially when the patient is already at risk due to other health factors. A recent study aimed to examine surgical antimicrobial prophylaxis prescribing patterns and its determinants, as well as the prevalence of SSIs in the surgical ward of a specialized hospital in Debre Berhan, Ethiopia.
The research was conducted from October 2022 to January 2023 and used patient medical record cards and patient interviews for data collection. These data were analyzed through SPSS V26.0 software, using multivariable logistic regression to establish determinants of surgical site infections.
Notably, the study revealed that 78% of patients were subjected to the inappropriate use of prophylactic antimicrobials, with ceftriaxone being the most frequently used prophylactic antibiotic, followed by a combination of ceftriaxone with metronidazole. Of these patients, a significant proportion, 61.9%, developed Surgical Site Infections (SSIs). The independent predictors for the occurrence of such infections were found to be a prolonged duration of the procedure (longer than one hour) and the inappropriate use of antimicrobial prophylaxis. Precisely, patients whose operations lasted more than an hour were nearly 3.39 times more likely to develop SSIs than those whose surgery lasted less than an hour.
Outcome reflects a need for heightened attention from clinicians and health policymakers. The inappropriate use of antimicrobial prophylaxis not only increases the public health problem of antimicrobial resistance but it also increases the risk of occurrence of surgical site infections, adverse drug reactions, and resultant medical care costs.
The findings of this study may contribute significantly to the promotion of rational antibiotic use, initiate national surveillance studies in regards to antibiotic usage and resistance, and reduce the unregulated use of antibiotics for common diseases. The insights gained from the Debre Berhan Comprehensive Specialized Hospital study can serve as a pilot study for future nationwide investigations.
Source: https://www.nature.com/articles/s41598-023-41834-7