Evaluation of the compliance of antibiotic prescribing with international clinical practice guidelines for surgical antibiotic prophylaxis at intermediate hospital Rundu, Namibia

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

Grantor dc:publisher

University of Namibia

Year dc:date.issued

2022

Author dc:creator

• Chola, Brian

• Surgical Antibiotic Prophylaxis
• Compliance
• Clinical practice

Language dc:language.iso

en

Handle dc:identifier.uri

http://hdl.handle.net/11070/3268

OAI identifier oai:identifier

oai:repository.unam.edu.na:11070/3268