Agrawal Mehul, Sharma Pramod K, Dhaneria S P
Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Rev Recent Clin Trials. 2017;12(1):59-64. doi: 10.2174/1574887111666160926103104.
Antimicrobial prophylaxis should be used in circumstances where efficacy has been demonstrated and benefits outweigh the risk. Each hospital must have an antibiotic policy that is implementable and fully adhered to.
A prospective observational study was conducted in 209 patients, admitted to wards of various surgical departments including surgery, obstetrics & gynaecology (O&G), otorhinolaryngology (ENT) and orthopaedics. Relevant antimicrobial use data of each patient was collected in a customized Case Record Form (CRF) from day one until patient was discharged.
Majority of the patients were young adults between 19-39 years of age. Preoperative antibiotics were given in 151 and postoperative antibiotics were prescribed in all. Third generation cephalosporins was the most frequently prescribed group. The selection of antibiotics by different departments varied greatly and many prescribed (n=85) two antibiotics for preoperative prophylaxis. Average duration of surgical prophylaxis was 6.25 days. In 90 patients, preoperative antibiotic was administered before 3 hours.
Despite routine interactive academic activities, pattern of antibiotic used was not as per guidelines suggested by competent authorities. Interventions are warranted to promote the development, dissemination and adoption of evidence based antibiotic policy. The policy should be simple, clear, noncontroversial, clinically relevant and implementable. The constant monitoring with periodic audit to ensure adherence is warranted.
在已证明疗效且益处大于风险的情况下应使用抗菌预防措施。每家医院都必须有一项可实施且能完全遵守的抗生素政策。
对209例入住包括外科、妇产科（O&G）、耳鼻喉科（ENT）和骨科等各个外科科室病房的患者进行了一项前瞻性观察研究。从第一天开始直至患者出院，在定制的病例记录表（CRF）中收集每位患者的相关抗菌药物使用数据。
大多数患者为19至39岁的年轻人。151例患者给予了术前抗生素，所有患者均给予了术后抗生素。第三代头孢菌素是最常处方的类别。不同科室对抗生素的选择差异很大，许多科室（n = 85）术前预防使用了两种抗生素。手术预防的平均持续时间为6.25天。90例患者在术前3小时内给予了抗生素。
尽管开展了常规的互动学术活动，但抗生素使用模式并不符合主管当局建议的指南。有必要进行干预，以促进基于证据的抗生素政策的制定、传播和采用。该政策应简单、明确、无争议、与临床相关且可实施。有必要进行持续监测并定期审核以确保遵守规定。
