Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India
Abstract Background Single-dose perioperative antibiotic prophylaxis (PAP) is recommended for clean, non-infectious surgeries to prevent surgical site infections. However, the common practice of unindicated use and prolonged use of antibiotics contributes to the development and spread of antibiotic...
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doaj-e9c7e5f50b704711bde2e19e389ce9ef2020-11-25T02:41:53ZengBMCPerioperative Medicine2047-05252019-09-018111210.1186/s13741-019-0121-3Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, IndiaAnna Machowska0Jonatan Sparrentoft1Shyam Kumar Dhakaita2Cecilia StålsbyLundborg3Megha Sharma4Department of Public Health Sciences, Global Health - Health Systems and Policy, Karolinska InstitutetDepartment of Public Health Sciences, Global Health - Health Systems and Policy, Karolinska InstitutetDepartment of Surgery, Ruxmaniben Deepchand Gardi Medical CollegeDepartment of Public Health Sciences, Global Health - Health Systems and Policy, Karolinska InstitutetDepartment of Public Health Sciences, Global Health - Health Systems and Policy, Karolinska InstitutetAbstract Background Single-dose perioperative antibiotic prophylaxis (PAP) is recommended for clean, non-infectious surgeries to prevent surgical site infections. However, the common practice of unindicated use and prolonged use of antibiotics contributes to the development and spread of antibiotic resistance (ABR). The present study explores the perioperative use of antibiotics among inpatients with surgical indications at surgery departments of a teaching (TH) and a non-teaching (NTH) tertiary care hospital in Madhya Pradesh, India. Methods Data was collected manually for all inpatients for 3 years (April 2008–August 2011). Patients with non-infectious surgical indications were selected for detailed analysis at the diagnosis group level. Results Out of 12,434 enrolled inpatients (TH 6171 and NTH 6263), the majority (> 85%) received antibiotics. None of the inpatients received the recommended single-dose PAP. The average duration of antibiotic treatment was significantly longer at the TH compared to the NTH (9.5 vs 4.4 days, p < 0.001). Based on the study aim, 5984 patients were classified in four diagnosis groups: upper or lower urinary tract surgery indications (UUTSI and LUTSI), and routine or emergency abdominal surgery indications (RASI and EASI). In both hospitals, quinolones were the most prescribed antibiotics for UUTSI (TH 70%, NTH 37%) and LUTSI (TH 70%, NTH 61%) antibiotic. In the TH, aminoglycosides (TH 32%) were commonly prescribed for RASI and imidazole derivatives (75%) for EASI. In the NTH, cephalosporins (39%) and imidazole derivatives (56%) were the most prescribed in RASI and EASI, respectively. Conclusions and recommendations High prescribing of antibiotics in all four selected diagnoses groups was observed at both hospitals. In spite of the recommended single-dose PAP, antibiotics were mainly prescribed for longer durations. The unrecommended use of antibiotics is a risk factor for the development of AMR. Improving the quality of antibiotic prescribing by a stewardship program focusing on the development and implementation of local prescribing guidelines is needed.http://link.springer.com/article/10.1186/s13741-019-0121-3Perioperative antibiotic prescribingNon-infectious surgery indicationsUrogenital surgeryAbdominal surgeryEmpirical prescribing |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anna Machowska Jonatan Sparrentoft Shyam Kumar Dhakaita Cecilia StålsbyLundborg Megha Sharma |
spellingShingle |
Anna Machowska Jonatan Sparrentoft Shyam Kumar Dhakaita Cecilia StålsbyLundborg Megha Sharma Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India Perioperative Medicine Perioperative antibiotic prescribing Non-infectious surgery indications Urogenital surgery Abdominal surgery Empirical prescribing |
author_facet |
Anna Machowska Jonatan Sparrentoft Shyam Kumar Dhakaita Cecilia StålsbyLundborg Megha Sharma |
author_sort |
Anna Machowska |
title |
Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India |
title_short |
Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India |
title_full |
Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India |
title_fullStr |
Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India |
title_full_unstemmed |
Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India |
title_sort |
perioperative antibiotic prescribing in surgery departments of two private sector hospitals in madhya pradesh, india |
publisher |
BMC |
series |
Perioperative Medicine |
issn |
2047-0525 |
publishDate |
2019-09-01 |
description |
Abstract Background Single-dose perioperative antibiotic prophylaxis (PAP) is recommended for clean, non-infectious surgeries to prevent surgical site infections. However, the common practice of unindicated use and prolonged use of antibiotics contributes to the development and spread of antibiotic resistance (ABR). The present study explores the perioperative use of antibiotics among inpatients with surgical indications at surgery departments of a teaching (TH) and a non-teaching (NTH) tertiary care hospital in Madhya Pradesh, India. Methods Data was collected manually for all inpatients for 3 years (April 2008–August 2011). Patients with non-infectious surgical indications were selected for detailed analysis at the diagnosis group level. Results Out of 12,434 enrolled inpatients (TH 6171 and NTH 6263), the majority (> 85%) received antibiotics. None of the inpatients received the recommended single-dose PAP. The average duration of antibiotic treatment was significantly longer at the TH compared to the NTH (9.5 vs 4.4 days, p < 0.001). Based on the study aim, 5984 patients were classified in four diagnosis groups: upper or lower urinary tract surgery indications (UUTSI and LUTSI), and routine or emergency abdominal surgery indications (RASI and EASI). In both hospitals, quinolones were the most prescribed antibiotics for UUTSI (TH 70%, NTH 37%) and LUTSI (TH 70%, NTH 61%) antibiotic. In the TH, aminoglycosides (TH 32%) were commonly prescribed for RASI and imidazole derivatives (75%) for EASI. In the NTH, cephalosporins (39%) and imidazole derivatives (56%) were the most prescribed in RASI and EASI, respectively. Conclusions and recommendations High prescribing of antibiotics in all four selected diagnoses groups was observed at both hospitals. In spite of the recommended single-dose PAP, antibiotics were mainly prescribed for longer durations. The unrecommended use of antibiotics is a risk factor for the development of AMR. Improving the quality of antibiotic prescribing by a stewardship program focusing on the development and implementation of local prescribing guidelines is needed. |
topic |
Perioperative antibiotic prescribing Non-infectious surgery indications Urogenital surgery Abdominal surgery Empirical prescribing |
url |
http://link.springer.com/article/10.1186/s13741-019-0121-3 |
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