Background: Surgical site infection (SSI) accounts for 15% of all nosocomial infections and represents the most common nosocomial infection.

Aims: To evaluate adherence to surgical prophylaxis guidelines and expenditure because of non-adherence to guidelines regarding antimicrobial agents (AMA) used for surgical prophylaxis.

Settings and Design: Prospective observational study in a tertiary care hospital.

Methods and Material: A prospective, observational study was conducted in 600 surgical cases from General surgery, Obstetrics and Gynaecology and Orthopaedics departments in a tertiary care hospital. Data were collected from medical case sheets about AMA used for surgical prophylaxis with regards to dose, timing, frequency, duration and expenditure on AMA. Appropriateness of surgical prophylaxis was evaluated with National treatment guidelines-2016 and hospital antibiotic policy.

Statistical analysis used: Microsoft excel 2013

Results: The Choice of antimicrobial agent was in adherence to guideline in 87.30%, 80.30% and 83.50% cases and total duration of surgical prophylaxis was in adherence to guidelines in only 15.74%, 16.16% and 0% cases in General surgery and Obstetrics and Gynaecology and Orthopaedics respectively. This non-adherence leads to additional expenditure on surgical prophylaxis which was Rs. 162.76 ± 168.50, Rs. 353.09 ± 140.00 and Rs. 130.06 ± 124.74 per patient for General surgery, Orthopaedics and Obstetrics and Gynaecology departments respectively.

Conclusions: Prolonged duration of surgical prophylaxis and in some extend inapt choice causes increased costs for the health care system, emphasizing on continued surveillance of surgical prophylaxis practices.

Keywords: Surgical prophylaxis, antimicrobial agents, expenditure, adherence.

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Sangeeta S. Dabhade

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