Santoshi John Ashutosh, Behera Prateek, Nagar Manoj, Sen Ramesh, Chatterjee Anirban
Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh 462020 India.
Department of Trauma and Emergency Medicine (Orthopaedics), All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh 462020 India.
Indian J Orthop. 2020 Nov 18;55(3):749-757. doi: 10.1007/s43465-020-00306-0. eCollection 2021 Jun.
Surgical antibiotic prophylaxis (SAP) has become the standard of care in orthopaedic surgery. Inappropriate usage of antibiotics (dosage, strength, and/or administration time and duration) can inadvertently result in superadded infections and antimicrobial resistance. The purpose of this study was to document and analyse the prescription patterns for SAP, and to investigate the factors associated with divergence from standard guidelines.
We conducted an online cross-sectional questionnaire-based study to collect information about the SAP practices of the members of the Indian Orthopaedic Association (IOA) using Google forms. A link to the questionnaire was sent by e-mails.
The overall response rate was 5.73%. While 97.3% respondents practised SAP routinely, the practice was not aligned with standard guidelines' recommendations. There was heterogeneity in the use of SAP in terms of choice of antibiotic(s), number of co-prescribed drugs, single- versus multiple-dose regimens, and the duration of therapy. The prescription practice patterns showed that orthopaedic surgeons almost always used broad-spectrum antibiotics for long durations, regardless of the type of surgery.
While Orthopaedic surgeons in India are practicing SAP, the pattern of antibiotic usage is heterogeneous. Variations were noted in the choice of antibiotics for different types of surgeries, time of administration, duration of usage in the postoperative period as well as co-prescriptions. This study highlights the urgent need for a comprehensive, rational, and robust national SAP policy for orthopaedic surgeries.
外科手术抗生素预防（SAP）已成为骨科手术的标准治疗方法。抗生素使用不当（剂量、强度和/或给药时间及持续时间）可能会意外导致额外感染和抗菌药物耐药性。本研究的目的是记录和分析SAP的处方模式，并调查与偏离标准指南相关的因素。
我们通过谷歌表单开展了一项基于在线横断面问卷调查的研究，以收集有关印度骨科协会（IOA）成员SAP实践的信息。问卷链接通过电子邮件发送。
总体回复率为5.73%。虽然97.3%的受访者常规进行SAP，但实践与标准指南的建议不一致。在抗生素选择、联合用药数量、单剂量与多剂量方案以及治疗持续时间方面，SAP的使用存在异质性。处方实践模式表明，骨科医生几乎总是长期使用广谱抗生素，而不管手术类型如何。
虽然印度的骨科医生在实施SAP，但抗生素使用模式存在异质性。在不同类型手术的抗生素选择、给药时间、术后使用持续时间以及联合处方方面都存在差异。本研究强调迫切需要针对骨科手术制定全面、合理且有力的国家SAP政策。
