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Abstract
The aim of the study is to analyze the effectiveness of the prophylactic usage of antibiotic in clean surgical cases as per WHO guidelines in the tertiary care hospital. To study the incidences of prophylactic usage of antibiotic in clean operative surgeries and analyze the deviations if any from the standard procedure established in the hospital. To find if a correlation exists between the frequency of incidences of drug resistance and the type of antimicrobial agent used in clean operative procedure,using post operative infection markers
Material and methods
The study was conducted at PK Das Institute Of Medical Sciences. The study was conducted as a hospital based prospective observational study. Variables collected were demographic factors like age,gender, previous history of surgery and Comorbid conditions. Past medical and medication history were recorded. Patient Demography, Prophylactic antibiotic used, Comorbidities present in patients prior to surgical intervention, Incidences of SSI occurrences within a period of two weeks post-surgery. Patients who underwent surgical procedure in the Dept. of ENT, and GENERAL SURGERYat P.K. DAS Hospital, a 300 bed tertiary care hospital. Patients undergoing clean surgery in the Dept. of Surgery and ENT who consented to participate in the study. Patients with no obvious source or signs of infection. Patients with co morbidities like uncontrolled diabetes, compromised immune system, concomitant infection present at other sites and pre-existing local immune response (foreign bodies, damaged tissue or hematoma) that are patient related pre-surgical risk factor for SSI. Patients undergoing emergency, bowel and urinary tract surgeries.
Discussion
Based on the inclusion and exclusion criteria, 94 patients from the Dept. of surgery who were to undergo clean surgery were recruited to participate in the study over a period of six months. Demographic information, medical history, thename of the surgical procedure to be adopted, existence of comorbidities was recorded.
Of the 94 patients who were included in the study 71 were adults (Older than 19 years to 60 years)who represented 75.53% of the study population and 23 were elderly (Above 60 years) representing 24.46% of the population. Analysis of the incidences of SSI with respect to distribution among genders revealed that there was no incidence of SSI in females patients involved in the study who constituted 40.42% of the study population, whereas there were 4 incidences among the males who constituted 59.57% of the population.
Result and conclusion
Surgical procedures carried out were 60 cases of Hernioplasty, 17 cases of Thyroidectomy 12 cases of Trendelenburg Procedure for Vericose Vein and 5 cases of Excisional Breast Biopsy. Among 60 patients who underwent Hernioplasty combination of Ampicillin 500mg +Cloxacillin 500 mg was used in 46 cases, Amoxicillin 1000 mg with 200 mg potassium Clavulanate in 6 cases and CEFOTAXIME 1gm in 8 cases. Of the 17 patients who underwent Thyroidectomy combination of Ampicillin 500mg +Cloxacillin 500 mg was used in 12 cases, Amoxicillin 1000 mg with potassium clavulanate 200 mg in 2 cases and Cefotaxime 1gm in 3 cases. Of the 12 patients who underwent Trendelenburg procedure for Vericose Vein, combination of Ampicillin 500mg +Cloxacillin 500 mg was used in 8 cases, Amoxicillin 1000 mg with 200 mg Potassium Clavulanate in 2patients and Cefotaxime 1gm in 2cases.Of the 5 patients who underwent Excisional Breast Biopsy combination of Ampicillin 500mg +Cloxacillin 500 mg was used in 4cases, and Cefotaxime 1gm in 1cases.
The study of effectiveness of prophylactic use of antibiotics in clean surgical cases was done.From the study it was found that the hospital was following the prophylactic antibiotic as per the WHO guidelines.