Evaluation of the compliance of antibiotic prescribing with international clinical practice guidelines for surgical antibiotic prophylaxis at intermediate hospital Rundu, Namibia
Loading...
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of Namibia
Abstract
Compliance with guidelines of surgical antibiotic prophylaxis (SAP) has been shown
to reduce the prevalence of surgical site infections by approximately 40%. However,
globally, 30 to 90% of antibiotics used for SAP purposes, are irrationally utilized.
The aim of this study was to estimate the level of compliance with international
clinical practice (ICP) guidelines for SAP and determine predictors of non compliance at Intermediate Hospital Rundu (IHR).
This was a quantitative, analytical retrospective clinical record review. Data were
collected from April 2019 to June 2019 from the clinical records of post-operative
patients in theatre unit using a standardized assessment form. Compliance was
evaluated in terms of correct antibiotic prophylaxis choice, timing, route of
administration, dose and discontinuation.
A total of 153 surgical procedures were evaluated. Of these, 149 warranted SAP but
only 92.0% received antibiotic prophylaxis. The level of compliance with SAP
guidelines was high with regards to correct route (99.3%) and moderate with respect to timing of administration (38.7%). Compliance with SAP guidelines was low with regards to correct antibiotic choice (15.3%), dosing (9.5%) and antibiotic
discontinuation within 24 hours (0.7%). None of the records complied with the
parameters of ICP guidelines for SAP. The main predictors of non-compliance to
prescribing correct SAP were general medical officers OR = 34.29 (95% CI 8.71 to
134.95) and specialists OR = 6.35 (95% CI 2.63 to 37.61). Elective surgical
procedures OR = 2.96 (95% CI 1.32 to 6.65) independently predicted non compliance to appropriate timing of antibiotic administration. General medical
officers OR = 53.03 (95% CI 8.35 to 336.66), specialist OR = 14.11 (95% CI 2.4 to
83.24) and age of patient OR = 1.09 (95% CI 1.02 to 1.16) were predictors of non compliance to correct dosing of prophylactic antibiotics.
Compliance with internationally recognized guidelines was sub-optimal. There is
need to develop local SAP guidelines and access to improve rational antibiotics use
in surgery at IHR
Description
A research thesis submitted in partial fulfillment of the requirements for the Degree of Master of Pharmacy (Clinical Pharmacy)
Keywords
Surgical Antibiotic Prophylaxis, Compliance, Clinical practice