BACKGROUND: Antibiotic prophylaxis is effective at reducing the risk of postoperative infection for nearly all types of surgery. Objective To audit the use of prophylactic antibiotics for elective surgery. SETTING: Khartoum Teaching Hospital, Sudan, a 1,000 bed tertiary level hospital. METHOD: A prospective study was conducted over a 9 month period; patients admitted for elective surgery were included consecutively. MAIN OUTCOME MEASURE: The use and administration of prophylactic antibiotics for elective surgery. RESULTS: A total of 1,768 patients with mean age 37.8 ± 14 years were recruited (females, 83.3 % of total) who underwent 1,814 surgical interventions. Of these 1,277 (70.4 %) of procedures were clean-contaminated. A total of 1,758 patients (99.4 % of total) received antibiotics for prophylaxis; 1,730 patients (97.9 %) were given antibiotics in the operating room; for 1,288 (74.5 %) of cases the antibiotics were considered 'recommended', while for 442 (25.5 %) they were not. Out of the patients for whom prophylaxis was recommended and was given, 725 (56.3 %) of patients received a broad spectrum antibiotic or unnecessary combination, 913 (70.9 %) received a sub-therapeutic dose, 120 (9.3 %) were given the first preoperative dose within the proper time window, and 1,250 (97 %) of patients had an extended duration of prophylaxis. Compliance with all stated criteria was achieved in only 47 (2.7 %) of observed prescriptions. CONCLUSION: This audit showed a wide gap between international standards and local practices; the authors call for urgent action to correct this situation through the development and implementation of local clinical guidelines.
BACKGROUND: Antibiotic prophylaxis is effective at reducing the risk of postoperative infection for nearly all types of surgery. Objective To audit the use of prophylactic antibiotics for elective surgery. SETTING: Khartoum Teaching Hospital, Sudan, a 1,000 bed tertiary level hospital. METHOD: A prospective study was conducted over a 9 month period; patients admitted for elective surgery were included consecutively. MAIN OUTCOME MEASURE: The use and administration of prophylactic antibiotics for elective surgery. RESULTS: A total of 1,768 patients with mean age 37.8 ± 14 years were recruited (females, 83.3 % of total) who underwent 1,814 surgical interventions. Of these 1,277 (70.4 %) of procedures were clean-contaminated. A total of 1,758 patients (99.4 % of total) received antibiotics for prophylaxis; 1,730 patients (97.9 %) were given antibiotics in the operating room; for 1,288 (74.5 %) of cases the antibiotics were considered 'recommended', while for 442 (25.5 %) they were not. Out of the patients for whom prophylaxis was recommended and was given, 725 (56.3 %) of patients received a broad spectrum antibiotic or unnecessary combination, 913 (70.9 %) received a sub-therapeutic dose, 120 (9.3 %) were given the first preoperative dose within the proper time window, and 1,250 (97 %) of patients had an extended duration of prophylaxis. Compliance with all stated criteria was achieved in only 47 (2.7 %) of observed prescriptions. CONCLUSION: This audit showed a wide gap between international standards and local practices; the authors call for urgent action to correct this situation through the development and implementation of local clinical guidelines.
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Authors: Esmita Charani; Aubrey J Cunnington; AlaEldin H A Yousif; Mohammed Seed Ahmed; Ammar E M Ahmed; Souad Babiker; Shahinaz Badri; Wouter Buytaert; Michael A Crawford; Mustafa I Elbashir; Kamal Elhag; Kamal E Elsiddig; Nadey Hakim; Mark R Johnson; Alexander D Miras; Mohamed O Swar; Michael R Templeton; Simon David Taylor-Robinson Journal: BMJ Glob Health Date: 2019-08-21