Need of improvement in timing of prophylactic antibiotic in elective surgery

• Published in: Journal of Nepal Medical Association Vol. 49; no. 179; pp. 204 - 208
• Main Authors: Shah, J N, Maharjan, S B, Piya, R, Shrestha, A, Shrestha, K, Basnet, N B, Gurung, H M
• Format: Journal Article
• Language: English
• Published: Nepal Nepal Medical Association 01.07.2010
• Subjects: Adolescent; Adult; Anti-Bacterial Agents - administration & dosage; Antibiotic Prophylaxis - standards; Cefazolin - administration & dosage; Cross-Sectional Studies; Drug Administration Schedule; Female; Humans; Male; Nepal; Practice Guidelines as Topic; Prospective Studies; Surgical Wound Infection - prevention & control; Time Factors; Nepal
• ISSN: 0028-2715; 1815-672X
• DOI: 10.31729/jnma.89

Infections in surgery are major concern of morbidity, mortality, and costs. Timely antibiotic prophylaxis before incision ensures optimum concentration of AP in blood and tissues to prevent surgical site infections . However, proper timing of AP remains problematic as reported by various studies, though none so far from Nepal. Aim of this prospective observational study was to assess and address the issues for improvements in timing of AP. The pattern of antibiotic prophylaxis were prospectively collected in respect to time of induction, and incision time were recorded on predesigned 'AP form'. The study included all the elective major cases who received AP of intravenous Cefazoline 1 g as per our existing protocol. The emergency surgeries and obstetric cases were excluded from the study. There were 125 cases of which 89% received AP before incision (63% within 5 minutes before incision), while 11% had AP after the incision and 1% within the recommended time period of 2 hour to 30 minutes before incision. Current practice of antibiotic prophylaxis (AP) needs improvement as per standard guidelines of AP within 2 hour to 30 before incision.