ORIGINAL ARTICLE
Prophylactic antibiotics prescription in ear, nose, throat and ophthalmologic procedures; an Iranian university hospital situational analysis
 
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1
Rhino- sinus, Ear and Skull base Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
 
2
Eye Research Center, Guilan University of Medical Sciences, Rasht, Iran
 
 
Submission date: 2018-02-02
 
 
Final revision date: 2018-02-21
 
 
Acceptance date: 2018-02-23
 
 
Online publication date: 2018-03-20
 
 
Publication date: 2018-03-20
 
 
Electron J Gen Med 2018;15(3):em42
 
KEYWORDS
TOPICS
Anatomy
 
ABSTRACT
Introduction:
Different prophylactic methods are introduced to prevent surgical site Infection. This study was conducted to evaluatesituation of prophylactic antibiotics (PA) usage in an Iranian university hospital.

Aims:
A cross sectional study.

Methods:
This study obtained data from 1010 patients’ medical files in 2015. These patients were admitted to a university otolaryngology (ENT) and ophthalmology hospital in north of Iran. Data from ordered prophylactic antibiotics considering induction time, type of antibiotic, duration of use, dosage amount and intervals was obtained to compare with international and national guidelines. Data analysis was performed by using Chi-square test at significance level of 95%.

Results:
402 (39.8%) patients were male and 608 (60.2%) ones were female. Mean age and standard deviation was 41.8±22.3 years old, and most participants were in 20-39 years of age. Ophthalmic and ENT related procedure was respectively conducted for 41.7% and 58.3% of patients. Septorhinoplasty and phacoemulsification were the commonest procedures. Totally 999 (98.9%) people received prophylactic antibiotics. Intravenous Cefazolin (for ENT procedures) and topical eye drop of Chloramphenicol 0.5% were prescribed mostly. We found poor accommodation between antibiotic use and guidelines for prophylaxis, mostly in case of duration of apply.

Conclusion:
Ordered prophylactic antibiotics is not as need as prescribed. Also, accommodation between prescription of antibiotics and available scientific guidelines was improper in this study.

 
REFERENCES (24)
1.
Erbil B, Ersoy G, Özkütük A, Akarca FA, Korkmaz T, Demir ÖF. The effects of oral antibiotics on infection prophylaxis in traumatic wounds. UlusTravmaAcilCerrahiDerg. 2014;20:231-5. https://doi.org/10.5505/tjtes.....
 
2.
Safargholi S, Musavi F, Faghani Y, Najjari S. Accommodation of prophylactic antibiotic prescription with international and national guidelines. Infectios & Tropical Journal. 2012;17:23-7.
 
3.
Azizi R, Jamshidi A, Taghipour MA. Effect of Antibiotic Prophylaxis in Preventing Wound Infection inElective Clean Surgical Procedures. Iranian Journal of surgery. 2007;15:13-7.
 
4.
Matthaiou DK, Peppas G, Falagas ME. Meta-analysis on surgical infections. Infectious disease clinics of North America. 2009;23:30-40. https://doi.org/10.1016/j.idc.... PMid:19393916.
 
5.
Owens CD, Stoessel K. Surgical site infections: epidemiology, microbiology and prevention. Journal of hospital infection. 2008;2:3-10. https://doi.org/10.1016/S0195-....
 
6.
Afhami Sh, Esmailpour BN, Boujar AN, Sayadi L. Antibiotic Prophylaxis before Surgeries. Iranian Jurnal of surgery. 2001;19:17-23.
 
7.
Shah GS, Christensen RE, Wagner WS, Pearce BK, Sweeney J. Retrospective evaluation of antimicrobial prophylaxis in prevention of surgical site infection in the pediatric population. Pediatric Anesthesia. 2014;24:994–8. https://doi.org/10.1111/pan.12... PMid:24823901.
 
8.
Society of Health Protection (ASHP). Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery. Therapeutic Guideline. Am J Health-Syst. 2013:582-667.
 
9.
Dale WB, Peter MH. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clinical Infectious Diseases. 2004;38:15-7. https://doi.org/10.1086/421095 PMid:15227616.
 
10.
Webb AL, Flagg RL, Fink AS. Reducing surgical site infections through a multidisciplinary computerized process for preoperative prophylactic antibiotic administration. The American Journal of surgery. 2006;192:663-8. https://doi.org/10.1016/j.amjs... PMid:17071203.
 
11.
Fonseca SN, Kunzle SR, Junqueira MJ, Nascimento RT, de Andrade JI, Levin AS. Implementing 1-dose antibiotic prophylaxis for prevention of surgical site infection. Archives of Surgery. 2006;141:1109-13. https://doi.org/10.1001/archsu... PMid:17116804.
 
12.
Bratzler DW, Houck PM. Surgical infection prevention guideline writers workgroup. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg. 2005;189:395-404. https://doi.org/10.1016/j.amjs... PMid:15820449.
 
13.
Eliopoulos GM, Cosgrove SE, Carmeli Y. The impact of antimicrobial resistance on health and economic outcomes. Clinical Infectious Diseases. 2003;36:7-14. https://doi.org/10.1086/375081 PMid:12766839.
 
14.
Raveh D, Muallem-Zilcha E, Greenberg A, Wiener-Well Y, Schlesinger Y, Yinnon AM. Prospective drug utilization evaluation of three broad-spectrum antimicrobials: cefepime, piperacillin-tazobactam and meropenem. Quarterly journal of medicine. 2006;99:397-406. https://doi.org/10.1093/qjmed/... PMid:16682440.
 
15.
Derakhshanfar A, khorshidi H, Mamani M, Niayesh A, Fallah M. Effect of prophylactic antibiotic in hernioplasty. Iranian Journal of Surgery. 2012;20:15-9.
 
16.
Askarian M, Reza Moravveji A, Assadian O. Prescription of prophylactic antibiotics for neurosurgical procedures in teaching hospitals in Iran. American journal of infection control. 2007;35:53-65. https://doi.org/10.1016/j.ajic... PMid:17482997.
 
17.
Farrahi A, Alizade M. Evaluation of prophylactic antibiotic prescription with standard guide pre-operatively. Tabriz university J of Med. 2010;13:21-6.
 
18.
Kanayama M, Hashimoto T, Shigenobu K, Oha F, Togawa D. Effective prevention of surgical site infection using a Centers for Disease Control and Prevention guideline-based antimicrobial prophylaxis in lumbar spine surgery. Journal of Neurosurgery. 2007;6:327-9. https://doi.org/10.3171/spi.20....
 
19.
Georgiou I, Farber N, Mendes D, Winkler E. The role of antibiotics in rhinoplasty and septoplasty. Rhinology. 2008;46:267-70. PMid:19145993.
 
20.
Yoo DB, Peng GL, Azizzadeh B, Nassif PS. Microbiology and antibiotic prophylaxis in rhinoplasty: a review of 363 consecutive cases. JAMA Facial PlastSurg. 2015;17:23-7. https://doi.org/10.1001/jamafa... PMid:25503811.
 
21.
Evren E, Babayigit M, Kuduban O. Postoperative cephazolin usage is sufficient for preventing infection after septoplasty procedure. Allergy Rhinol (Providence). 2011;2:54–7.
 
22.
Ciulla TA, Starr MB, Masket S. Bacterial endophthalmitis prophylaxis for cataract surgery: an evidence-based update.Ophthalmology. 2002;109:13-24. https://doi.org/10.1016/S0161-....
 
23.
Xavie OAC, Tomita S, Marques MPC, Felix F, Ferraiolo PN, Laurindo RSS. Antibiotic prophylaxis in otolaryngologic. Int. Arch. Otorhinolaryngol. 2013;17:85-91.
 
24.
Jahromi A, Meymane A, Honarvar H, Khalighi HR. Effect of therapeutic antibiotic prescription before and after tonsillectomy and adenotonsilectomy. (Persian edition) BirjandSci J of Med. 2006;13: 12-6.
 
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