Abstract

USE OF ANTIMICROBIAL PROPHYLAXIS FOR OBSTETRIC AND GYNECOLOGICAL SURGERIES AND SENSITIVITY PATTERN OF INFECTIVE ORGANISMS

Dr. Chavda Falguni M*, Dr. Karelia Bharti N, Dr. Singh Anil P.

ABSTRACT

Title: “Use of antimicrobial prophylaxis for obstetric and gynaecological surgeries and sensitivity pattern of infective organisms.” Objective: To study the effectiveness of various antimicrobial agents used to prevent and treat post surgical infection along with the current trend of prescribing patterns, the rate of wound infection and sensitivity pattern of causative organisms. Materials and Method: All the patients admitted in the department of Obstetrics and Gynaecology and scheduled for surgical procedure and received surgical prophylaxis were reviewed daily. Details of antimicrobial agents upto their discharge were noted in case record form. Patients who showed signs of infection were identified and rate of infection was calculated. Culture and sensitivity was done in these patients and details of antimicrobial agents given for treatment were noted. Result: Total 209 patients were included in study, out of which 158 were from obstetrics and 51 were from gynaecology department. Cefotaxime was the most commonly given antimicrobial agent to the obstetrics [72.78%] and gynaecology [98.03%] patients 30 minutes prior to the surgery. Combinations of Cefotaxime, Metronidazole and Gentamicin [obstetrics – 79.74% and gynaecology – 96.07%] were commonly given parenterally followed by combination of Cefixime and Metronidazole [obstetrics- 89.87% and gynaecology – 68.62%] orally to all the patients during postoperative stay.0.63% [1 out of 158] of obstetric and 1.96% [1 out of 51] of gynaecology patient developed infection. The overall rate of infection was 0.95 %. E.coli was the common organism found in both groups which was found to be sensitive to Amikacin. Amoxicillin- clavulinic acid (oral) and Amikacin (iv) were given for treatment to patients who developed wound infection in obstetric [0.63%] and gynaecological [1.96%] patients after culture sensitivity report. Conclusion: Combination of cephalosporin, aminoglycoside and nitroimidazole groups were effective for prevention and treatment of surgical site infection of obstetrics and gynaecological surgeries

Keywords: Antimicrobial agents, Surgical prophylaxis, Surgical site infection.