Infection and Drug Resistance (Sep 2020)

The Association Between Incorrect Use of Antibiotic Prophylaxis and in-Hospital Surgical Site Infections – A Prospective Observational Study

  • Tefera GM,
  • Feyisa BB,
  • Taye GM,
  • Tesfaye Umeta G,
  • Negash Bereded F,
  • Dinsa Ayeno H,
  • Alemayehu Gadisa D,
  • Melaku Kebede T

Journal volume & issue
Vol. Volume 13
pp. 3063 – 3072

Abstract

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Gosaye Mekonen Tefera,1 Beshadu Bedada Feyisa,2 Getu Melesie Taye,3 Gurmu Tesfaye Umeta,1 Fekadu Negash Bereded,4 Hunduma Dinsa Ayeno,1 Diriba Alemayehu Gadisa,3 Tsegaye Melaku Kebede5 1Department of Pharmacy, Clinical Pharmacy Course Unit, Ambo University, Ambo, Ethiopia; 2Department of Public Health, Human Nutrition Course Unit, Ambo University, Ambo, Ethiopia; 3Department of Pharmacy, Pharmacology Course Unit, Ambo University, Ambo, Ethiopia; 4School of Medicine, Department of Surgery, Wachemo University, Hossana, Ethiopia; 5School of Pharmacy, Department of Clinical Pharmacy, Jimma University, Jimma, EthiopiaCorrespondence: Gosaye Mekonen Tefera Email [email protected]: Surgical site infection (SSI) is the most prevalent in developing countries where 61– 90% of cases develop in-hospital. The study aimed to assess the correctness of antibiotic prophylaxis (AP) use, the incidence of in-hospital SSI, and its determinants.Patients and Methods: A 3-month hospital-based prospective observational study design was used on general surgery patients. The criteria for identification of SSI were performed based on the Center for Disease Control and Prevention’s (CDC’s) definition of SSI. The correctness of AP was performed based on the American Society of Health System Pharmacist 2013 guideline (ASHP). Multiple stepwise backward logistic regression analysis was used at p-value < 0.05 to predict SSI.Results: Of 269 adult patients, the type of admission was almost equal between emergency and elective surgery. The mean (± SD) age of the study participants was 41.95± 17.764. Only 19.7% of the study participants used AP correctly. The incidence rate of in-hospital SSI was 16.7% (45/269), which corresponds to 45/4736 or 9.5/1000 person-days. Independent predictors for SSI were American Society of Anesthesiology (ASA) class III–IV (p-value < 0.0001), patients with age-adjusted Charlson co-morbidity index (CCI) of ≥ 1 score (p value=0.008), and incorrect use of AP (p-value =0.025).Conclusion: Incorrect antibiotic prophylaxis use contributed to an increased risk of SSI, which needs urgent attention in the present study area.Keywords: antibiotic prophylaxis, surgical site infection, predictors, JUMC

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