Adherence to prophylactic antibiotic guidelines in surgical patients in a tertiary care hospital in Colombo

PVN Wijesinghe; IU Ratnasekera; CD Ratnayake; CN Wijesinghe; AGAC Jayasekera; TNMS Fernando; WGHC Wackwella; V Jayasuriya; A Pathirana

Authors

PVN Wijesinghe Faculty of Medical Sciences , University of Sri Jayewardenepura
IU Ratnasekera Faculty of Medical Sciences , University of Sri Jayewardenepura
CD Ratnayake Faculty of Medical Sciences , University of Sri Jayewardenepura
CN Wijesinghe Faculty of Medical Sciences , University of Sri Jayewardenepura
AGAC Jayasekera Faculty of Medical Sciences , University of Sri Jayewardenepura
TNMS Fernando Faculty of Medical Sciences , University of Sri Jayewardenepura
WGHC Wackwella Faculty of Medical Sciences , University of Sri Jayewardenepura
V Jayasuriya Faculty of Medical Sciences , University of Sri Jayewardenepura
A Pathirana Faculty of Medical Sciences , University of Sri Jayewardenepura

Abstract

Objective: To assess the prescribers adherence to surgical antibiotic prophylactic guidelines issued by the Sri Lanka Collage of Microbiologists

Methods: Patients admitted to six surgical wards of Colombo South Teaching Hospital were included in the descriptive cross-sectional study. It was carried out for a period of one month (October to November 2009). Patients who underwent surgeries were included to assess the adherence to prophylactic antibiotic guidelines issued by Sri Lanka Collage of Microbiologists. Data was entered in a form which included the type of surgery, names and doses of prophylactic antibiotics, time and duration of administration. Data was collected on every other day from the bed head tickets by the members of the research group.

ICU patients and patients who were on therapeutic antibiotics for pre-operative infections were excluded from the study.

Results: Out of the 128 bed head tickets of patients who underwent surgeries, prophylactic antibiotics were administered in 71%. Adherence to drug, dose, timing and number of doses were 54%, 43%, 70% and 26% respectively. In 45 (54 %) surgeries, prophylaxis was continued for more than 24 hours. In general, gastrointestinal, urological surgeries overall adherences to SLCM guidelines were 45%, 2%, 36% respectively. None of the vascular surgeries were consistent with the SLCM guidelines. Overall adherence to guidelines was 27%.

Conclusions: Adherence to separate aspects of guidelines for surgical prophylaxis has to be improved. Interventions have to be made on improving awareness and surveillance on adherence to SLCM guidelines.