IMPACT OF EDUCATIONAL INTERVENTION ON SURGICAL PROPHYLAXIS PRACTICES TO CONTAIN ANTIBIOTIC RESISTANCE

Jasmeet Singh, *Inderpal Kaur and Suneet Jindal

ABSTRACT

1. To assess the surgical prophylaxis practices in a specific group of surgeries (elective clean uncomplicated surgeries). 2. To orient the surgical team regarding surgical prophylaxis and its implication by developing an educational learning module as part of antibiotic stewardship programme. 3. To assess post educational surgeon’s compliance of adhering to the surgical prophylaxis guidelines Methodology: - This was a part of multi-institutional interventional study carried out at a local level in Government Medical College & Hospital, Amritsar; a 1000 bedded tertiary care health institution. With approval from institutional ethics committee, total of 150 consecutive patients were studied for pre and post-intervention for 1year as per predefined inclusion and exclusion criteria. Pre existing data including choice of antibiotics, route, dose and timing of first and repeat doses were recorded from case-records of inpatients in surgical ward. Data was compared with clinical practice guidelines for antimicrobial prophylaxis in surgery. After recognizing the extent of problem, experts gathered and prepared a module to educate the surgeons. Prescriptions not in accord to guidelines were discussed with the group of surgeons in their monthly meet by conducting Lecture using PowerPoint slides (1 hour). Result: Use of prophylactic antibiotics was compared with Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery in 150 post operative patients. Choice of antibiotic, dose, timing of first and repeat dose was compared with the guidelines and was found that these were in accord to guidelines in 75%, 68% ,34% and 10% patients respectively. Post-interventional data showed adherence to educational module resulting in 75% improvement in antibiotic utilization in patients without altered incidence of SSI. Conclusion: Educational intervention and training of surgeons has vital role in eliminating irrational use of antibiotics, checking the emergence of antibiotic resistance. Antibiotics are unique drugs as they lose efficacy over time and they must be used sparingly so we need institutional multidisciplinary committee for guideline development & implementation.

Keywords: Antibiotic stewardship, Resistance, Prophylaxis.