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Abstract     Introduction: Surgical site infection (SSI) is the most common post operative complication and represents a significant burden in terms of patient morbidity and mortality and cost to health services. Appropriate antimicrobial agents (AMAs) prophylaxis has been shown to be effective in reducing the incidence of SSI. So it was thought worthwhile to study the prescription pattern regarding use of AMAs in perioperative surgical and gynaecological patients in our hospital. Aims and Objectives: 1. To study different regimens of prophylactic AMAs and their prescription patterns for the peri – operative surgical and gynaecological patients in MNR Medical College and Hospital. 2. To study and compare the efficacy and adverse effects of various groups of these AMAs. Material and Methods: A prospective observational study was conducted in 100 patients. Interviews and hospital records and physical examination were used to obtain data. Distribution of patients was by age (years), nutritional status and location of wound. Appropriateness of pre-operative antibiotic prophylaxis was assessed as per guidelines of Scottish Intercollegiate Guideline Network (SIGN) and American Society of Health System Pharmacists (ASHP). Result: 69% patients received preoperative AMAs. Cefotaxime and Metronidazole was the most commonly prescribed combination in this group followed by Amikacin alone. Cefotaxime was prescribed in majority of these cases. SSIs were seen in 4 patients out of 100 patients. Discussion: 7 regimens of AMAs were used. 3 drug combinations in 25 patients, 2 drug combinations in 34 patients, single drug prophylactically administered in 41 patients. AMAs were administered prophylactically 2.5-4 hours (and for 8 days post operatively). Surgical Site Infection (SSI) was seen in 4 patients similar as reported in the study by Kumar Kakkar (2010). In our study AMAs were administered 1 hour prior to surgery. Only 10% of patients received AMAs just before incision. Postoperative AMAs were administered for a mean duration of 7 days during hospital stay and for another 4 days after discharge. There was no significant difference in effectiveness of the regimens used. Duration of hospitalization, surgical site infection (SSI) are as per previous study. The regimens were used in therapeutic doses for reasonably short period to avoid adverse drug reactions. Conclusion: In various surgical patients, the AMAs are properly used in our hospital and needs no modifications. The AMA regimen, in therapeutic doses for a short period reduces the period of hospitalization and SSI in surgical patients treated under proper sterile conditions.

Keywords: antimicrobial agents.



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