Assessment on practice of prophylactic antibiotic use in obstetric and gynecologic surgeries at St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia

Abstract

<p><strong>Background</strong>: Surgical site infection (SSI) is one of major complication of obstetric and gynecological surgical procedures. It represents a significant burden in terms of patient’s morbidity, mortality and hospital costs. Surgical antibiotic prophylaxis (SAP) is administration of short course of antimicrobial agent prior to surgery to prevent SSI. For optimal prophylaxis, SAP should be used when indicated, and with recommended agent, timing and duration.</p> <p><strong>Objective: </strong>To assess practice of prophylactic antibiotics use in obstetric and gynecologic surgeries at Saint Paul’s Hospital&nbsp; Millennium Medical colleague (SPHMMC), Addis Ababa, Ethiopia</p> <p><strong>Method</strong>: - Retrospective chart review was conducted on patients who undergo obstetric and gynecologic surgeries performed from January to March 2020 at Saint Paul’s Hospital Millennium Medical colleague (SPHMMC). Data was collected using structured questionnaire. The study includes 331 patients using systematic sampling method. Information was extracted by reviewing the patients’ records. The questionnaires were filled out by trained data collectors. The data was analyzed using IBM SPSS statistics version 23.0.0.0 and presented using figures and tables.Descriptive statistics and Fisher’s exacttest was employed to assess association among variables. P-value less than 0.05 was considered statistically significant. Proportions and percentages were used for descriptions of data.</p> <p><strong>Result</strong><strong>: </strong>A total of 331 patients with mean age of 29 years were included in the analysis. Of these, all received SAP. The overall compliance to surgical antibiotic prophylaxis guideline was 2 out of 331surgeries (0.6%). Selection of Surgical antibiotic prophylaxis drug was 80.4% compliant to American colleague of Obstetrics &amp; Gynecologic and WHO guidelines. The most discordant parameter from SAP guidelines was duration (99.4%) followed by timing of first dose (30.2%) and selection of drug (17.5%). Most commonly used agent was Ampicillin (82.4%).</p> <strong>Conclusion</strong>: Current practice of Surgical antibiotic prophylaxis is hugely divergent from SAP guidelines. Extended period of SAP use and use of broader spectrumantibiotics for was noticed. Preparing instutionalized guideline to reinforce appropriate SAP use &amp; training to ordering &amp; administrating health care providers are essential forreducing costs and antibiotic resistance rates.