Abstract

ADHERENCE TO PERI-OPERATIVE PROPHYLACTIC ANTIBIOTIC TIMINGS IN CLEAN ORTHOPEDIC SURGERIES INVOLVING METALLIC IMPLANTS: A RETROSPECTIVE OBSERVATIONAL STUDY

Dr. Kamalasundar T, *Dr. Udaykumar P, Dr. Manjuprasad MS

ABSTRACT

Surgical site infection (SSI) after a surgery can lead to prolonged misery to the patient, prolonged hospital stay, increased re-hospitalization with greater use of health & economic resources. Prevention of SSI requires bundle of care approach. One element of care practiced in hospitals is administration of intravenous antibiotic prophylaxis within 60 minutes before incision in any clean orthopedic surgery involving metallic implants. This observational study was conducted in order to observe the current pattern of surgical antibiotic prophylaxis practiced in a tertiary care hospital in Mangalore and find ways to improvise the quality of care. Drugs used for prophylaxis were intravenous b.d doses of cefaperazone sulbactam, ceftriaxone sulbactam, cefuroxime, amoxycillin clavulinic acid. Among 100 patients only 56% were found to have received prophylaxis within 60 minutes before incision. Fortunately nil case of SSI was detected, though edema and serous discharge were observed in 4 patients. Prolonged duration of antibiotic continuation was found in the all the patients but the recommended duration for continuation is only 24 hr. Quality of care can be improvised by conducting CME for surgeons and hospital staff on antibiotic prophylaxis. Regular audits are needed to check adherence to antibiotic policy.

Keywords: clean orthopedic surgery, metallic implant, prophylaxis, surgical site infection.