Abstract:
Background: Use of prophylactic antibiotics is the most common intervention to avoid surgical
site infections (SSI). Indiscriminate use of antibiotics may lead problems including, increasing
cost and the emergence of resistance of microorganisms. Current guideline recommends
intravenous (IV) cefuroxime 1500 mg, metronidazole 500 mg and co-amoxiclav 1200 mg for
surgical prophylaxis.
Objectives: To identify prophylactic antibiotic usage pattern in surgical unit of Teaching
Hospital Peradeniya. Further, the study focused to find out surgical site infection rate, risk
factors for post-operative surgical site infections and common causative microorganisms for
those infections.
Methodology: Prophylactic antibiotic usage pattern for vascular, upper and lower gastro intestinal, urological and general surgeries were observed in patients who underwent
surgery, within three months and were followed up for three months period to observe surgical
site infections. Wound swabs were collected from infected patients and causative
microorganisms were identified. Information on risk factors was identified using bed head
tickets. All the results were subjected to statistical evaluation using Statistical Package for Social
Sciences 20.
Results: Out of 350 surgeries, only 38% were given antibiotic prophylaxis. IV cefuroxime
750 mg was the most frequently used antibiotic for prophylaxis (58.1%). Others are IV
metronidazole 500 mg (26.82%) and co-amoxiclav 1200 mg (11.72%). SSI rate was reported
as 8%. Lower GI surgeries were reported to have highest number of infections (28.75%).
Most prevalent organism was Pseudomonas spp. (45.5%). Only the duration of the surgery
(p<0.05) was observed as the risk factor for reported SSIs.
Conclusions: Although the standard regime of IV cefuroxime is 1500 mg, the current usage is
750 mg. Other than that the usage pattern of antibiotic prophylaxis is much similar to current
national guidelines.
