Perioperative antimicrobial prophylaxis in surgery and adherence to guidelines

Introduction: Surgical Antimicrobial Prophylaxis (SAP) lowers post-operative surgical site infection (SSI) if used with American Society of Health-System Pharmacists (ASHP) guidelines. Objective: The present study was carried out with the aim to assess the rational use of antibiotics for prevention of SSI and to look for adherence to ASHP guidelines. Materials and Method: This was a prospective study done in 228 patients in surgical ward/ICU who received antibiotics for surgical prophylaxis. Results: There was unnecessary SAP pre-operatively in 22.80 % respondents. Post-operatively 10.08 % patients received single antibiotic, 79.39% received two, 14.91% received three, one received four antimicrobials. Antibiotics were used for procedures where antibiotic prophylaxis is not indicated There was appropriate antimicrobial selection in 31.58% surgeries .Appropriate initial time of SAP was in 87.72% surgeries .Route, dose, dose interval were appropriate in all surgeries. The duration of prophylaxis was consistent with the guideline recommendation in 47.37% patients. SSI developed in 3.5% cases. Patients were discharged without complications. Conclusion: Utilization of antimicrobials for surgical prophylaxis are not in accordance with standard treatment guidelines. There was overuse of antimicrobials .Costly and branded drugs were used. Effective educational intervention, development of local guidelines / protocols can help to overcome this.