TITLE:
Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital
AUTHORS:
Abubaker Ibrahim Elbur, M. A. Yousif, Ahmed S. A. El Sayed, Manar E. Abdel-Rahman
KEYWORDS:
Prophylactic Antibiotics; Wound Infection; Obstetrics and Gynecology; Sudan
JOURNAL NAME:
Health,
Vol.6 No.2,
January
26,
2014
ABSTRACT: Purpose: This study was conducted to audit
prophylactic antibiotic use and to quantify the rate of wound infection. Methods:
Across-sectional prospective study was conducted in the Obstetrics and
Gynecology Department in Khartoum Teaching Hospital, Sudan during March 1st
to 31st October 2010. All Patients (aged >18 years) were included. Results:
Overall 725 patients were included. The performed surgical procedures were 751;
of these 578 (76.9%) were Caesarean sections. Overall rate of wound infection was
7.8%. The rate of wound infection among patients operated on for caesarean section
and abdominal hysterectomy was 8.3%, and 9.2%, respectively. Multivariate
logistic analysis showed that body mass index [BMI] ≥ 30 kg/m2 OR
2.1, 95% CI (1.1 - 4.0), (P = 0.019) was the major independent risk factor for
occurrence of wound infection. Evaluation of prescriptions’ parameters against the
stated criteria showed that 113 (15.8%) patients were given antibiotics with
adequate spectrum of activity, 611 (85.3%) given sub-dose/s, 83 (11.6%)
received the first preoperative dose/s in a proper time window, and 716 (100%)
had prophylaxis for extended duration. Overall conformity to the stated criteria
for the evaluation of prescription’s parameters was not achieved in all
prescriptions. Conclusions: In this setting, antibiotics were irrationally used
and wound infection rate was high, and the situation calls for multiple
interventions to correct the situation, through the activation of the infection
control committee in the hospital and development of antimicrobial subcommittee
to develop policies for the use and auditing of prophylactic antibiotics.