Assessment of Rational use of Antibiotics in Orthopedic Surgery Procedures

Introduction: Appropriate use of antimicrobial agents is important and is essential if the usefulness of antibiotic is to be preserved and the further spread of resistance is to be limited. Antibiotics are one of the pillars of modern medicine are important in prophylaxis and treatment of infectious diseases. Objective: To assess rational use of antibiotics for prophylaxis and treatment among patients in orthopedic department who undergone surgery. Methods: A prospective and observational study was conducted on 300 medical records of orthopedic patients who undergone surgery. Data was collected by using structured questionnaire from Sep 2019 to Dec 2019 and then analyzed using SPSS version 20.0 software. Results: Out of 300 patients who undergone surgery 179 patients were male and 121 patients were females. Based on age group classification 30 – 40 years of age i.e. 50 (38.46%) was mostly affected. The most common diagnosis was ORIF(43.07%) followed by THR (20%) of cases. The most frequently prescribed antibiotics for prophylaxis Cefuroxime (67.40%), amikacin (14.91%) and for treatment Cefuroxime (58.17%), amikacin (18.90%). The commonly used antibiotics combination for prophylaxis is Ceftriaxone + Amikacin+ Cefuroxime (20.68%) and treatment includes Ceftriaxone+ Cefuroxime + clavulanic acid (34.04%). It was found that 50% of cases for prophylaxis was inappropriate where as 73.07 % of treatment antibiotics failed to adhere guidelines. Conclusion: Generally, this study indicated that orthopedic patients underwent surgical procedures by majority of patients were ORIF and THR. Mostly prescribed antibiotics were cefuroxime, Amikacin. This study result indicated some level of inappropriateness in antibiotic prescription.