Appropriateness of surgical antimicrobial prophylaxis in a teaching hospital in Ghana : findings and implications

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Appropriateness of surgical antimicrobial prophylaxis in a teaching hospital in Ghana : findings and implications


JournalJAC Antimicrobial Resistance
Article typeJournal research article – Clinical research
Publication date – Sep – 2022
Authors – Sefah Israel Abebrese, Denoo Edinam Yawo, Bangalee Varsha, Kurdi Amanj, Sneddon Jacqueline, Godman Brian
Keywordsantimicrobial resistance, Ghana, Surgical antimicrobial prophylaxis, surgical site infections
Open access – Yes
SpecialitySurgical infection
World region Western Africa
Country: Ghana
Language – English
Submitted to the One Surgery Index on September 17, 2022 at 3:08 am
Abstract:

Background: Surgical site infections (SSIs) are among the most common infections seen in hospitalized patients in low- and middle-income countries (LMICs), accounting for up to 60% of hospital-acquired infections. Surgical antimicrobial prophylaxis (SAP) has shown to be an effective intervention for reducing SSIs and their impact. There are concerns of inappropriate use of SAP in Ghana and therefore our audit in this teaching hospital. Method: A retrospective cross sectional clinical audit of medical records of patients undergoing surgery over a 5-month duration from January to May 2021 in Ho Teaching Hospital. Data collection form was designed to collect key information including the age and gender of patient, type and duration of surgery, choice and duration of SAP. Data collected were assessed for the proportion of SAP compliance with Ghana standard treatment guidelines (STG) and its association with various patient, surgical wound and drug characteristics. Results: Of the 597 medical records assessed, the mean age of patients was 35.6± 12.2 years with 86.8% (n=518) female. Overall SAP compliance with the STG was 2.5% (n=15). SAP compliance due to appropriate choice of antimicrobials was 67.0% (n=400) and duration at 8.7% (n=52). SAP compliance was predicted by duration of SAP (pConclusion: SAP compliance rate was suboptimal, principally due to a longer duration of prescription. Quality improvement measures such as education and training of front-line staff on guideline compliance, coupled with clinical audit and regular updates, are urgently needed to combat inappropriate prescribing and rising resistance rates.

OSI Number – 21754

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