Current Surgical Antibiotic Prophylaxis Practices: A Survey of Orthopaedic Surgeons in India
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ORIGINAL ARTICLE
Current Surgical Antibiotic Prophylaxis Practices: A Survey of Orthopaedic Surgeons in India John Ashutosh Santoshi1 · Prateek Behera1 · Manoj Nagar2 · Ramesh Sen3 · Anirban Chatterjee4 Received: 12 September 2020 / Accepted: 31 October 2020 © Indian Orthopaedics Association 2020
Abstract Background Surgical antibiotic prophylaxis (SAP) has become the standard of care in orthopaedic surgery. Inappropriate usage of antibiotics (dosage, strength, and/or administration time and duration) can inadvertently result in superadded infections and antimicrobial resistance. The purpose of this study was to document and analyse the prescription patterns for SAP, and to investigate the factors associated with divergence from standard guidelines. Methods We conducted an online cross-sectional questionnaire-based study to collect information about the SAP practices of the members of the Indian Orthopaedic Association (IOA) using Google forms. A link to the questionnaire was sent by e-mails. Results The overall response rate was 5.73%. While 97.3% respondents practised SAP routinely, the practice was not aligned with standard guidelines’ recommendations. There was heterogeneity in the use of SAP in terms of choice of antibiotic(s), number of co-prescribed drugs, single- versus multiple-dose regimens, and the duration of therapy. The prescription practice patterns showed that orthopaedic surgeons almost always used broad-spectrum antibiotics for long durations, regardless of the type of surgery. Conclusion While Orthopaedic surgeons in India are practicing SAP, the pattern of antibiotic usage is heterogeneous. Variations were noted in the choice of antibiotics for different types of surgeries, time of administration, duration of usage in the postoperative period as well as co-prescriptions. This study highlights the urgent need for a comprehensive, rational, and robust national SAP policy for orthopaedic surgeries. Keywords Surgical antibiotic prophylaxis · Elective surgery · Trauma surgery · Antibiotic · Prescription practice · Perioperative antibiotic prophylaxis · Surgical site infection · Orthopaedic association
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s43465-020-00306-0) contains supplementary material, which is available to authorized users.
Surgical site infections (SSI) are associated with significant morbidity and mortality. Perioperative antibiotic prophylaxis, also frequently known as surgical antibiotic prophylaxis (SAP), is prescribed with the aim to reduce
* Prateek Behera [email protected]
1
Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh 462020, India
John Ashutosh Santoshi [email protected]
2
Manoj Nagar [email protected]
Department of Trauma and Emergency Medicine (Orthopaedics), All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh 462020, India
3
Ramesh Sen [email protected]
Senior Director, Institute of O
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