Evaluation of surgical antimicrobial prophylaxis use in Ethiopia: Prospective study

Appropriate use of surgical antimicrobial prophylaxis can prevent approximately 40 to 60% of surgical site infections. Inappropriate  use  is  associated  with  emergency  of antimicrobial resistance,  occurrence  of  side  effects  and  increased  health  care  cost.  We aimed to evaluate surgical antimicrobial prophylaxis use of Hawassa University Referral Hospital against standard guideline Prospective  observational  study was done on  105  patients  who  undergone  major  surgical  procedure between  March 2 and  May 2,  2015.  Data was collected from patient medication charts, operational and anesthesia notes, by direct observation and patients’ interview using pre-tested questionnaire. All patients were followed daily before, during and after operation till discharge.  We  coded  and  cleaned  the  data  using  Epi-Data  version  3.1  and exported to SPSS for window version 20.0 software for analysis. Overall adherence to American society of health-system pharmacists (ASHP) for surgical antimicrobial prophylaxis use guideline was not observed for all parameters evaluated.  Surgical antimicrobial  prophylaxis  was  indicated  only  in  85(80.9%)  patients  but  administered  in  103  (98.1%) patients. Choice  of  antimicrobial  was  discordant  for  all  patients  for  whom  antimicrobial  prophylaxis  was indicated  and  administered.  Ceftriaxone  was  the  most  frequently  administered  73(70.9%)  antibiotics followed  by  combination  of  Ceftriaxone  and  Metronidazole  25(24.3%). Among 98.1% of patients who took antimicrobial  prophylaxis  ,  time  of  first  dose  administration and  duration  of administration were concordant in 38(36.9%) and 19(19.1%),  respectively.  Overall adherence to ASHP guideline was far from optimal for all parameters evaluated.  Key words: Antimicrobial prophylaxis, American health system pharmacists, Ethiopia.