PRESCRIPTION AUDIT OF VARIOUS ANTIBIOTICS GIVEN IN CASE OF ACUTE APPENDICITIS OF ACUTE ABDOMEN TO PATIENTS ADMITTED IN SURGICAL WARDS OF A MEDICAL COLLEGE OVER SIX MONTHS: A RETROSPECTIVE STUDY.

Wadagbalkar P.*, Raipurkar S. and Joshi A.

ABSTRACT

Introduction: Acute abdomen is a condition described in surgery as acute pain in abdomen. Most common cause of it is acute appendicitis unless otherwise specified.[1] It can be due to infection due to some obstruction in the lumen of appendix. Deficiency of dietary fiber and increased consumption of refined carbohydrates may be important[2] Treatment is emergency appendectomy if patient presents in the beginning of pain in abdomen before formation of any appendicular abscess which is treated conservatively by Oscner sheren regime including antibiotics and intravenous fluids.[3] In either of condition whether operative or conservative treatment, antibiotics do occupy an important place in treatment. Objective:To evaluate what antibiotics are given in treatment of acute appendicitis in this hospital routinely and how much they are rational , was the main objective of this study. Material & Methods:It was a retrospective study in which case papers of 188 patients of acute appendicitisadmitted in hospital over six months from 1stjune 2012 till 30thdecember 2012 were analyzed for clinical, biochemical,& microbiological reports, Antibiotics prescribed, their dose,duration,number of antibiotics given simultaneously, route of a drug administration, duration of stay in hospital etc. Result: Out of 188 patients case papers examined,over 90 % patients were prescribed two antibiotics combination of Ceftrioxone or Cefotaxime &, Metronidazole, average duration of stay was 7.5 days, around 75.1 % patients were given more than two antibiotics adding Gentamicin empirically. Being a common clinical entity, 75% patients were treated irrationally. Average antibiotic prescribed per patient were 2.3.Average hospital stay was 7.1 days. Conclusion-Acute appendicitis is a quite common condition in general surgery, requiring routinely third generation Cephalosporin and Metronidazole, yet antibiotic policy should be developed in tertiary care center to avoid irrational uses of antibiotics such as combining Aminoglycoside with third generation cephalosporin leading to emergence strains. Antibiotic policy should be displayed in surgery ward to promote rational prescription.

Keywords: Appendicitis, Cefotaxime, Metronidazole, Gentamicin, Amikacin, Rational, Irrational use of Antibiotics.