A COMPARATIVE EVALUATION OF PRESCRIBING PRACTICE OF ANTIBIOTIC PROPHYLAXIS IN HOSPITALS OF POKHARA VALLEY

Abstract

The main objective of the study was to assess the prescribing practice of antibiotic prophylaxis for different
surgeries in hospitals of Pokhara valley. A descriptive, quantitative, retrospective study was used to evaluate
the patients who have undergone surgery between 15th April 2002 – 14th April 2003. A total of 950 patients
were taken from the medical record for the study. Data about patient (age, sex), surgery (type and indication),
antibiotic/s prophylaxis (dose, duration) and length of hospital stay were collected. Caesarean Section (CS)
was the common surgery in Western Regional Hospital (WRH) followed by cholecystectomy, 31.1% and
24.4% respectively. In Manipal Teaching Hospital (MTH), dilatation and currettage (D and C, 21.6%) was
the most common surgery followed by hysterectomy (21%). The mean length of stay in MTH for CS surgery
was 7.97 days whereas 7.01 days for WRH. Significant difference was found in length of stay of two hospitals
(p<0.05). Antibiotic prophylaxis was given preoperatively in MTH (87%) and WRH (79.5%) respectively.
Antibiotic prophylaxis was given intraoperatively in 1.2% cases of MTH. In MTH, the total antibiotic
duration in all surgeries is higher than WRH, significant difference was found only in cholecystectomy
(p<0.05). In both hospitals Ampicillin+Cloxacillin was the most commonly used regimen, 12.4% in WRH
and 34% in MTH. In WRH, Ciprofloxacin/Cefotaxim was also used by 12.4%. More than 79.1% of the
patients were exposed to, at least, two antibiotics as a prophylaxis in WRH where as more than 63.0% in
MTH. Penicillin was found to be mostly used in both hospitals.

Key Words: Antibiotic prophylaxis, Surgery.