International Journal of Advances in Medicine | October 2020 | Vol 7 | Issue 10 Page 1492
International Journal of Advances in Medicine
Ravi G et al. Int J Adv Med. 2020 Oct;7(10):1492-1497
http://www.ijmedicine.com
pISSN 2349-3925 | eISSN 2349-3933
Original Research Article
Compliance of surgical antimicrobial prophylaxis practices in the
departments of general surgery and orthopaedics at a tertiary care
centre in India
Gandham Ravi*, Gaurav Chikara, Arkapal Bandyopadhyay, Shailendra Handu
INTRODUCTION
Antimicrobial (AM) Stewardship Programme practices
are at primitive state in Indian healthcare settings despite
the existence of standard guidelines, and according to the
evidence shown by the national level survey carried out
by the Indian Council of Medical Research (ICMR) in the
year 2013, only up to 30% of the healthcare institutions
have been found out to be practicing the AM stewardship
guidelines and recommendations.
1
Analysis of the data
regarding the AM consumption between the years 2000
and 2010 shown that there is an increase in the
consumption of AM agents with increased usage of the
last resort AMs to treat the infections. All these findings
have shown the need for the rationale prescription of
these agents and the compliance with the guidelines and
recommendations.
2
Most of the data at the global level
also shows inappropriateness in the surgical AM
prophylaxis.
3
Prophylactic AM administration in order to
prevent the infection and there by promoting the wound
healing without any complications at the surgical site is
the core aspect of undertaking any surgical procedure.
ABSTRACT
Background: Antimicrobial (AM) prophylaxis is one of the major interventions to prevent surgical site infections.
The guideline recommendations are meant for helping the surgeons to select the rationale and effective approach
while. This study aimed to assess the compliance of surgical AM prophylaxis in terms of choice of antibiotic, duration
and timing of administration using standard international and national guidelines.
Methods: A prospective observational study was done in General Surgery and Orthopaedics over a period of one
year. All the relevant data was collected and analysed. Results were then compared with standard Clinical Practice
Guidelines (CPGAS-2013 and ICMR-2017).
Results: In terms of choice of AM, 31.32% of the cases from general surgery and 97.59% of the cases from
orthopaedics according to ICMR 2017 guidelines; 28.91% of the cases from general surgery and none of the cases
from orthopaedics according to CPGAS 2013 guidelines were found to be compliant. In terms of duration of
prophylaxis, 28.91% and 22.89% of the cases from general surgery were found to be compliant to ICMR 2017 and
CPGAS 2013 guidelines respectively; but none of the cases from orthopaedics were compliant to either of the
guidelines. Timing of administration was found to be compliant with the guidelines in both the departments.
Conclusions: Surgical prophylaxis practices were found to be partially compliant with the guidelines in the selected
departments.
Keywords: AM, Antibiotic, Antimicrobial prophylaxis, Antimicrobial stewardship practices, Compliance
Department of Pharmacology, All India Institute of Medical Sciences, Rishikesh, India
Received: 23 August 2020
Accepted: 08 September 2020
*Correspondence:
Dr. Gandham Ravi,
E-mail: gandhamravi89@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2349-3933.ijam20203996