Prospective Evaluation Of Antimicrobial Prophylaxis And Other Risk Factors For Surgical Site Infection At Surgical Ward | 23517
Clinical Pharmacology & Biopharmaceutics
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Background: Appropriately administered surgical antimicrobial prophylaxis (AMP) reduces the incidence of surgical site
infections (SSIs). However, inappropriate prescribing and excessive use of antimicrobials increase antimicrobials resistance as
well as adverse drug events and costs.
Objective: To determine the rate and predictors of SSI and evaluate surgical AMP administration against American Society of
Health-System Pharmacists (ASHP) guideline on AMP in surgery at surgical ward of Jimma University Specialized Hospital
Methods: A prospective cohort study was conducted on major surgical procedures from February ? April, 2012. The data
were analyzed using SPSS version 16.0. Binary logistic regression analysis was conducted to identify factors and independent
predictors associated with SSIs. P-value < 0.05 was considered to be statistically significant.
Results: The rate of SSI was 12.2%. Total compliance to the guideline was not observed at all. AMP was indicated in 128
(71.1%) of all procedures but administered for 104 (81.2%) of those who required AMP. Choice of AMP was discordant at all
and ceftriaxone was one of the most commonly used drugs. Timing of first dose was discordant in 92 (71.9%) of 128 procedures
to which AMP was indicated. With regard to the duration of prophylaxis 98 (94.2%) was discordant with the guideline. AMP
administration significantly reduced SSI (P = 0.005; OR= 6.2). Age greater than 60 years (P = 0.025; OR= 4.7), duration of
surgery (P = 0.022; OR = 4.4), history of surgery in the previous one year (P = 0.013; OR = 7.3) and smoking (P = 0.008; OR=
8.8) were found to be independent predictors for SSI.
Conclusions: SSI rate is lower than reports from other African countries but still higher than developed countries. Adherence
to ASHP guideline is far from optimal.
Belay Yimam Yesuf is currently a Lecturer and Clinical pharmacist at Southern Africa Nazarene University (SANU), Swaziland. He received his MSc in Clinical
Pharmacy at the age of 31 years from Jimma University. Before joining SANU 2 months back he worked at Jimma University as a Lecturer and Clinical pharmacist
and taught courses for MSc clinical pharmacy & undergraduate students. He gave clinical service to the community at the hospital and supervised students during
their clinical attachment at different patient wards. In addition, he gave in-service training on clinical pharmacy for pharmacist and also advising postgraduate and
undergraduate pharmacy students in their independent research projects.
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