PRESCRIBING PATTERN OF ANTIMICROBIAL DRUGS IN POST OPERATIVE PATIENTS IN A TERTIARY CARE HOSPITAL OF ASSAM

Abstract

Background: Surgical site infections remain a major cause of post-operative morbidity, prolonging hospitalization and increasing treatment cost. Rational and judicious use of antimicrobial agents is essential for their prevention and treatment, and prescribing patterns require periodic evaluation to identify irrational use and curb the emergence of antimicrobial resistance. Objective: To study the type and dosage schedule of antimicrobial drugs used in post-operative patients and to evaluate the antimicrobial treatment pattern in these patients. Methods: A cross-sectional observational study was conducted using case records of post-operative patients admitted to the surgical wards of Assam Medical College & Hospital, Dibrugarh, between June and September 2014, after obtaining Institutional Ethics Committee (Human) approval. Patients above 15 years of age of either sex undergoing major surgery were included; patients below 15 years and those with diabetes mellitus or tuberculosis were excluded. Demographic data, diagnosis, type of surgery, and antimicrobial dosage schedules were recorded on a predesigned performa. Results: Of 250 patients studied, 133 (53.2%) were female and 117 (46.8%) were male, with the 15–29-year age group most represented (28.0%). Cholecystectomy was the commonest surgery (27.6%), followed by other abdominal surgeries (23.6%), appendicectomy (14.4%) and genital surgeries (14.4%). Piperacillin–tazobactam (4.5 g) was the most frequently prescribed antimicrobial (29.5%), followed by metronidazole (16.25%), ceftriaxone–sulbactam (13.5%), amikacin (13.5%), ceftriaxone (8.25%), imepenem (3.5%) and meropenem (1.25%). Conclusion: Piperacillin–tazobactam followed by metronidazole were the most commonly used agents for post-operative antimicrobial prophylaxis in this tertiary care hospital of Assam. Judicious selection of antimicrobials with the narrowest effective spectrum, guided by local microbiological sensitivity patterns, is recommended to minimise the future emergence of antimicrobial resistance.