Adherence to Surgical Antibiotic Prophylaxis in Surgery: A Prospective Study

Ann Nema Thomas ^1* and Sandra Magdalene ²

Ensuring timely and guideline-adherent antibiotic prophylaxis minimizes surgical site infections and enhances patient outcomes.

Abstract

Background: Pre-operative antibiotic prophylaxis is crucial to reduce the risk of post-operative infections at surgical sites, thereby minimizing patient burden, prolonged hospital stays, and additional medication needs. Guidelines recommend administering prophylactic antibiotics 30-60 minutes before incision to achieve optimal outcomes. This study aimed to evaluate adherence to these guidelines in a hospital setting. Methods: A prospective observational study was conducted over two months, including 685 surgical cases from various departments such as gynecology, orthopedics, urology, and pediatrics. Cardiac cases were excluded. A clinical pharmacist monitored the administration of antibiotics from the receiving room to the recovery room. If surgery exceeded four hours, a second antibiotic dose was administered. Post-surgery, cases were monitored for surgical site infections (SSIs). Compliance with hospital guidelines on prophylactic antibiotic administration was evaluated. Data were analyzed using Microsoft Excel. Results: Of the 685 cases, 629 (91.82%) received appropriate antibiotics per hospital guidelines, while 8.18% deviated from the protocol. The most commonly used antibiotics were Cefuroxime axetil (30%), followed by Ceftazidime (15%) and Cefoperazone (15%). Ciprofloxacin was the least used (1%). Antibiotics were administered within the specified time frame in 86% of cases. Compliance rates varied by department and type of surgery, with elective surgeries showing higher adherence than emergency surgeries. Conclusion: The study highlights the need for improved compliance with antibiotic prophylaxis guidelines, specifically ensuring administration within 60 minutes of incision to prevent SSIs and hospital-acquired infections. Adherence to hospital antibiotic policies is essential for optimal surgical outcomes and best practices in the operating theatre.

Keywords: Surgical site infection, pre-operative prophylaxis, antibiotic adherence, surgical guidelines, infection control

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