Journal Title: پاییز 90
Article title: Antibiotic Prophylaxis before Surgeries

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Page From: 28 To: 35      
Article abstract:
Introduction & Objective: Although one of the most influential modality for decreasing wound infections is utilizing prophylactic antibiotic before surgery, inappropriate use of antibiotics before operation is a major concern and can increase the prevalence of antibiotic resistant strains and adverse reactions, and negatively affect hospital budget. The aim of this study is to assess the appropriateness of surgical antibiotic prophylaxis among patients admitted in the surgical wards of a teaching hospital relative to the international guidelines and standards. Materials & Methods: In this descriptive cross-sectional study, surgical antibiotic prophylaxis of 172 surgeries was evaluated prospectively but discontinuously. During 2 years in six surgical wards of a teaching hospital. Information including demographic data of patients, wound classification, type of surgery, indication, selection of the prophylactic antibiotics, time, interval, duration and route of antibiotic administration were collected through a questionnaire; the sources of data were patient’s records and charts, physicians and nurses. Then the results of prescribed prophylactic antibiotics were compared with the international guidelines on antibiotic prophylaxis in surgery. All data were coded, entered, and analyzed using SPSS 13. For descriptive statistics, data were summarized using tables, measures of dispersion and central value, and frequency and percentages were calculated and presented. Results: Among 172 operations, the overall adequacy of indication of prophylactic antibiotic (PA) was 71.5%. Of the 108 patients with indication, the timing of PA was appropriate in 95 (88%) patients; the choice of antibiotic was adequate in 44 patients (40.7%); the dosage and interval of PA were appropriate in 34 (31.5%) and 26 patients (24%), respectively, and the duration of antibiotic prophylaxis was appropriate in 5 cases (4.6%). The route of drug administration in all patients, except one, was intravenous. Considering all variables (indication, selection of the prophylactic antibiotic, time, interval, duration and route of antibiotic administration), the overall appropriateness of PA was 4.6% (5 cases) according to guidelines. Conclusions: Considering all variables (indication, selection of the prophylactic antibiotic, time, interval, duration and route of antibiotic administration), pre-operation antibiotic prophylaxis had little concordance with standard guidelines, especially regarding prolonged duration of antibiotic use, though after excluding the variable of duration of antibiotic administration, the prophylactic antibiotic was prescribed appropriately in one-fourth of patients. For appropriate use of antibiotic before operations, interventions including developing local hospital guidelines, implementing educational programs, and monitoring antibiotic prophylaxis should be considered.
Article KeyWords:
Antibiotic, Prophylaxis, Operation
Article Authors:

	دکتر شیرین افهمی	First Author	afhamish@sina.tums.ac.ir
	دکتر نگین اسمعیل پور بزاز	Other Author
	دکتر نیره بوجار آرانی	Other Author
	لیلا صیادی	Other Author