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Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India
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 resistan...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734588/ https://www.ncbi.nlm.nih.gov/pubmed/31523421 http://dx.doi.org/10.1186/s13741-019-0121-3 |
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author | Machowska, Anna Sparrentoft, Jonatan Dhakaita, Shyam Kumar StålsbyLundborg, Cecilia Sharma, Megha |
author_facet | Machowska, Anna Sparrentoft, Jonatan Dhakaita, Shyam Kumar StålsbyLundborg, Cecilia Sharma, Megha |
author_sort | Machowska, Anna |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6734588 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67345882019-09-14 Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India Machowska, Anna Sparrentoft, Jonatan Dhakaita, Shyam Kumar StålsbyLundborg, Cecilia Sharma, Megha Perioper Med (Lond) Research 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. BioMed Central 2019-09-10 /pmc/articles/PMC6734588/ /pubmed/31523421 http://dx.doi.org/10.1186/s13741-019-0121-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Machowska, Anna Sparrentoft, Jonatan Dhakaita, Shyam Kumar StålsbyLundborg, Cecilia Sharma, Megha Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India |
title | 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_short | 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 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734588/ https://www.ncbi.nlm.nih.gov/pubmed/31523421 http://dx.doi.org/10.1186/s13741-019-0121-3 |
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