Department of Pharmacy, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia.
Sci Rep. 2023 Sep 6;13(1):14689. doi: 10.1038/s41598-023-41834-7.
The inappropriate use of surgical antimicrobial prophylaxis is a common cause for increased risk of morbidity and mortality from surgical site infection in patients who underwent surgical procedures. The study aimed to evaluate surgical antimicrobial prophylaxis prescribing patterns, Surgical Site Infection (SSI), and its determinants in the surgical ward of Debre Berhan Comprehensive Specialized Hospital, northeast Ethiopia. A prospective cross-sectional study was conducted from October 1st 2022 to January 31st, 2023. Data collected from patient medical record cards and patient interviews were entered and analyzed using SPSS V26.0. The determinants of surgical site infection were determined from the multivariable logistic regression. P-value ≤ 0.05 was considered statistically significant. Ceftriaxone (70.5%) followed by a combination of ceftriaxone with metronidazole (21.90%) was the most frequently used prophylactic antibiotic. One hundred fifty-nine (78%) of patients were exposed to inappropriately used prophylactic antimicrobials and 62.2% of these were exposed to inappropriately selected antibiotics. One hundred twenty-six (61.9%) patients developed Surgical Site Infection (SSI). Duration of procedure longer than an hour and inappropriate use of antimicrobial prophylaxiswere the independent predictors for the occurrence of surgical site infections. Patients whose operation was lasted in longer than an hour were 3.39 times more likely to develop SSI compared to those whose operation was completed in less than an hour, AOR = 3.39 (95% CI: 1.24-9.30). Similarly, controlling the effect of other covariate variables, individuals who were given inappropriate antimicrobial prophylaxis were 6.67 times more likely to develop SSI compared to those given appropriate prophylaxis, AOR = 6.67 (95% CI: 1.05-42.49). The high rate of SSI requires due attention from clinicians as well as health policymakers. Duration of surgical procedure greater than an hour and inappropriate antimicrobial prophylaxis use was the independent predictor of surgical site infections.
手术抗菌预防用药不当是导致手术患者手术部位感染发病率和死亡率增加的常见原因。本研究旨在评估 Debre Berhan 综合专科医院外科病房的手术抗菌预防用药模式、手术部位感染 (SSI) 及其决定因素。这是一项 2022 年 10 月 1 日至 2023 年 1 月 31 日进行的前瞻性横断面研究。从患者病历卡和患者访谈中收集的数据输入并使用 SPSS V26.0 进行分析。使用多变量逻辑回归确定手术部位感染的决定因素。P 值≤0.05 被认为具有统计学意义。头孢曲松 (70.5%)是最常用的预防性抗生素，其次是头孢曲松与甲硝唑的联合用药 (21.90%)。159 (78%)的患者接受了不当使用的预防性抗菌药物治疗，其中 62.2%的患者接受了不当选择的抗生素治疗。126 (61.9%)的患者发生了手术部位感染 (SSI)。手术时间超过 1 小时和抗菌预防用药不当是手术部位感染发生的独立预测因素。与手术时间少于 1 小时的患者相比，手术时间超过 1 小时的患者发生 SSI 的可能性增加了 3.39 倍，AOR=3.39(95%CI：1.24-9.30)。同样，在控制其他协变量变量的影响下，与接受适当预防用药的个体相比，接受不适当抗菌预防用药的个体发生 SSI 的可能性增加了 6.67 倍，AOR=6.67(95%CI：1.05-42.49)。高 SSI 率需要临床医生和卫生政策制定者给予应有的关注。手术时间超过 1 小时和抗菌药物预防用药不当是手术部位感染的独立预测因素。
