A Study of Antibiotics Prescription Pattern in Pre, Intra & Post Operative Period to Patients Who Later Developed Surgical Site Infections in a Tertiary Care Centre.

Abstract

Introduction: Antimicrobial resistance(AMR) has emerged as major public health problem all over the world which can be controlled in paying great attention to judicious use of them. In 2012, Indian Council of Medical Research(ICMR) started Antibiotic Stewardship Program(ASP) to reduce Surgical site infections(SSIs) by doing right antimicrobial prophylaxis and emphasised to prevent drug resistance. Thus, we aimed to see the pattern of antibiotics prescribed in pre, intra and post-operative period to patients, who later developed SSIs. Methodology: After local IEC-DHR approval, Data is collected using Retrospective Descriptive Type Study Design in tertiary care centre of government of Maharashtra. All patients’ medical records who undergone Surgeries performed in General Surgery, Obstetrics-Gynaecology, Orthopaedics Departments and later developed surgical site infections in post-operative period are included. Duration of Study is 6 Months (Jan’23 to Jun’23). Only antimicrobials used are recorded & Data from Prescriptions are analysed using latest versions of M.S.Excel. Results: Total 71 case records are studied and Females found more. 19-30years of age patients are more. Antimicrobials of Third generation cephalosporins are used most frequently in Pre, Intra and post-op period. Among it, Inj. Ceftriaxone was prescribed more commonly as ‘Monocef’. Half of Antimicrobials are prescribed with Generic names and match Daily Defined Dose(DDD) recommended by WHO. Average duration of post-operative treatment was 12-13days. Antibiotics were prescribed till discharge to all. Conclusion: In our study, case records of patients who later developed surgical site infections are studied to know Demographic profile. Type, Dose, Interval of Pre, Intra and Post-operative prophylaxis were according to ASP of India by ICMR. Prescription pattern is Most commonly Polypharmacy and Fixed Drug Combinations were preferred. I.V. was used more than P.O. Treatment modifications are done in 1/4^th cases after microbiological reports of swabs of infected sites and this need to be increased.