Compliance with Antibiotics Prophylaxis Guideline in Surgical Patients in ICUs of a Teaching Referral Hospital

Abstract

Antimicrobial prophylaxis used for surgical procedures remains one of the measures for the prevention of surgical site infections (SSIs). The present study was designed to assess the compliance with clinical practice guideline for antimicrobial prophylaxis in variable surgeries conducted in the intensive care units (ICUs) of a major referral hospital. This cross-sectional investigation was carried out by prospective data collected from October 2017 to March 2018 in the intensive care unit (ICU) of Nemazi hospital in Shiraz. Demographic characteristics, surgery type as well as antibiotic treatment were gathered from medical records and entered in data collection forms. We reviewed compliance and adherence of prophylactic antibiotic administration to the Infectious Diseases Society of America (IDSA) guideline and evaluated the courses of antimicrobial drugs. If an antibiotic administrated for surgical prophylaxis was different from the guideline, the antibiotic was classified as non-guideline-based antibiotics. Most patients participated in this study were male (64.5%). Only 8.75% of the administrated antibiotics chosen for surgical prophylaxis were found to be appropriate antibiotic prescriptions; however, those patients receiving appropriate antibiotics prescribed an inappropriate dosage. In addition, the antibiotics were administrated with inappropriate durations in all cases. Our findings indicated that adherence to the IDSA international guideline seems to be far from ideal in Namazi hospital for antimicrobial prophylaxis, resulting in the unsuitable administration of a wide variety of antibiotics.