scholarly journals Evaluation of Antibiotic Use in Surgical Patients at Rspau Dr. S. Hardjolukito Yogyakarta With ATC/DDD System

2022 ◽  
Vol 1 (3) ◽  
pp. 149-153
Author(s):  
Unsa Izzati ◽  
Nur Abdul Goni
Keyword(s):  
Antibiotic Use ◽  
Surgical Patients

Antibiotik merupakan terapi pengobatan untuk infeksi bakteri karena antibiotik telah mengurangi morbiditas serta meningkatkan keselamatan pasien yang mengalami infeksi bakteri. Penggunaan antibiotik yang semakin besar, maka semakin besar pula kemungkinan terjadinya resistensi antibiotik. Saat ini 70% bakteri penyebab infeksi di Rumah sakit setidaknya telah resisten terhadap paling tidak satu antibiotik yang biasa digunakan untuk pengobatan. Penelitian ini adalah penelitian deskriptif evaluative dengan pendekatan kuantitatif menggunakan metode ATC/DDD. Pengambilan data dilakukan secara retrospektif menggunakan rekam medik RSPAU dr. S. Hardjolukito Yogyakarta. Hasil penelitian menunjukkan kuantitas penggunaan antibiotik anbacim (cefuroxime) paling tinggi yaitu sebesar 17,413 DDD/100 pasien-hari dan ceftriaxone 10,784 DDD/100 pasien-hari. Penggunaan antibiotik secara kuantitas paling banyak pada pasien bedah adalah anbacim (cefuroxime).

Antibiotic Use and Antimicrobial Resistance of Surgical Patients with Peritonitis at a Tertiary Referral Hospital in Rwanda

2018 ◽  
Vol 19 (4) ◽  
pp. 382-387 ◽  
Author(s):  
Jennifer Rickard ◽  
Christian Ngarambe ◽  
Leonard Ndayizeye ◽  
Blair Smart ◽  
Robert Riviello ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antibiotic Use ◽  
Referral Hospital ◽  
Surgical Patients ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital

Pattern of Peri-Operative Antibiotic Use among Surgical Patients in a Regional Referral and Teaching Hospital in Uganda

2020 ◽  
Vol 21 (6) ◽  
pp. 540-546
Author(s):  
Hiroki Saito ◽  
Kyoko Inoue ◽  
James Ditai ◽  
Andrew D. Weeks
Keyword(s):  
Teaching Hospital ◽  
Antibiotic Use ◽  
Surgical Patients

Risk Factors for the Development of Clostridium difficile-Associated Diarrhea During a Hospital Outbreak

1991 ◽  
Vol 12 (6) ◽  
pp. 345-348 ◽  
Author(s):  
Alain Thibault ◽  
Mark A. Miller ◽  
Christina Gaese
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Systemic Disease ◽  
Gastrointestinal Surgery ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Surgical Patients ◽  
Convenience Sample ◽  
Significant Difference ◽  
Clostridium Difficile Associated Diarrhea

AbstractObjective:To evaluate the risk factors associated with a nosocomial outbreak of Clostridium difficile-associated diarrhea.Design:Case-control study with two control groups.Setting:University-affiliated urban hospital.Patients:A convenience sample of 26 patients was chosen out of a total of 78 hospitalized patients with C difficile-associated diarrhea, defined as the presence of diarrhea and a positive C difficile cytotoxin assay or stool culture. Twenty-six controls were matched for age, gender, ward, and date of admission; 18 additional controls were matched to surgical patients for date and ward of admission, as well as for the type of surgical procedure performed.Results:Significant risk factors for the development of C difficile-associated diarrhea were gastrointestinal surgery (exposure odds ratio [EOR] = 7.9, p= .004, 95% confidence interval [CI]= 1.9, 35), use of neomycin (EOR= 15.6, p=.012, 95% CI=1.7, 92), clindamycin (EOR=15.6, p=.005, 95% CI=1.7, 92), metronidazole (EOR=5.7,p=.02,95%CI= 1.4, 25), and excess antibiotic use (mean number of antibiotics = 4.2 versus 1.4, p<.00005). The presence of systemic disease and the use of antacids or immunosuppressive drugs were similar in cases and controls. In surgical patients, no specific antibiotic could be linked to C difficile-associated diarrhea because of uniform perioperative antibiotic use. There was a significant difference in the number of antibiotics administered to cases and controls (mean = 3.1 versus 1.9, p< .005).Conclusions:The results suggest that control of nosocomial C difficile-associated diarrhea may be attained by minimizing the administration of antibiotics, avoidance of high-risk antibiotics, and having a high index of suspicion of C difficile-associated diarrhea in patients who develop diarrhea after gastrointestinal surgery. Perioperative administration of metronidazole, when given with other antibiotics, failed to protect against the development of C difficile-associated diarrhea.

scholarly journals Discordance to ASHP Therapeutic Guidelines Increases the Risk of Surgical Site Infection

2021 ◽  
Vol 14 (11) ◽  
pp. 1088
Author(s):  
Fauna Herawati ◽  
Rika Yulia ◽  
Heru Wiyono ◽  
Firdaus Kabiru Massey ◽  
Nurlina Muliani ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Surgical Procedures ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Surgical Patients ◽  
Defined Daily Dose ◽  
Site Infection ◽  
Therapeutic Guidelines ◽  
Bed Days ◽  
American Society

Clean surgery without contamination does not require prophylactic antibiotics, but there are high-risk surgical procedures that may cause infection and/or involve vital organs such as the heart, brain, and lungs, and these indeed require the use of antibiotics. This study aimed to determine the quantity of antibiotic use based on the defined daily dose (DDD) per 100 bed days and the quality of antibiotic use based on the percentage of concordance with The American Society of Health-System Pharmacists (ASHP) therapeutic guidelines (i.e., route of administration, time of administration, selection, dose, and duration). This includes the profiles of surgical site infection (SSI) in surgical patients from January through June 2019. The study subjects were 487 surgical patients from two hospitals who met the inclusion criteria. There were 322 patients out of 487 patients who had a clean surgical procedure. Ceftriaxone (J01DD04) was the most used antibiotic, with a total DDD/100 bed days value in hospitals A and B, respectively: pre-surgery: 14.71, 77.65, during surgery: 22.57, 87.31, and postsurgery: 38.34, 93.65. In addition, 35% of antibiotics were given more than 120 min before incision. The lowest concordance to ASHP therapeutic guideline in hospital A (17.6%) and B (1.9%) was antibiotic selection. Two patients experienced SSI with bacterial growths of Proteus spp., Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli. The usage of prophylactic antibiotics for surgical procedures was high and varied between hospitals. Hospital B had significantly lower concordance to antibiotic therapeutic guidelines, resulting to a higher infection rate, compared with hospital A. ASHP adherence components were then further investigated, after which antibiotic dosing interval and injection time was found to be a significant predictor for positive bacterial growth based on logit–logistic regression. Further interventions and strategies to implement antibiotic stewardship is needed to improve antibiotic prescriptions and their use.

Prophylactic Antibiotics in Pediatric Surgery

PEDIATRICS ◽  
1982 ◽  
Vol 69 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Richard W. Kesler ◽  
Linda J. Guhlow ◽  
Frank T. Saulsbury
Keyword(s):  
Pediatric Surgery ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Surgical Patients ◽  
Postoperative Prophylaxis ◽  
Preoperative Prophylaxis

The frequency and appropriateness of prophylactic antibiotic use in children less than 6 years of age who received surgery were examined. Antibiotics were prescribed for 62% of children who had surgery, and prophylaxis was the sole reason for antibiotic use in 73% of the patients. Prophylactic antibiotics were administered inappropriately with respect to timing or duration to 42% of the children receiving preoperative prophylaxis, 67% receiving intraoperative prophylaxis, and 55% receiving postoperative prophylaxis. Thus, prophylaxis alone is the major indication for antibiotic use in pediatric surgical patients, and prophylactic antibiotics are frequently administered inappropriately.

Prevalence of Nosocomial Infections After Surgery in Greek Hospitals: Results of Two Nationwide Surveys

2004 ◽  
Vol 25 (4) ◽  
pp. 319-324 ◽  
Author(s):  
Achilleas Gikas ◽  
Maria Roumbelaki ◽  
John Pediaditis ◽  
Pavlos Nikolaidis ◽  
Stamatina Levidiotou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nosocomial Infections ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Developed Countries ◽  
Surgical Patients ◽  
Prevalence Studies ◽  
Day Range ◽  
Greek Hospitals

AbstractObjective:To determine the frequency and type of nosocomial infections (NIs) (especially surgical-site infections [SSIs]), risk factors, and the type and duration of antibiotic use among surgical patients in Greek hospitals.Design:Two point-prevalence studies.Setting:Fourteen Greek hospitals.Patients:Those in the hospitals during two prevalence surveys undergoing surgery during their stay.Results:In the 1999 survey, 129 of 1,037 surgical patients had developed 148 NIs (14.3%). A total of 1,093 operations were registered, and 49 SSIs (4.5%) were found. In the 2000 survey, 82 of 868 surgical patients had developed 88 NIs (10.1%). A total of 902 operations were registered, and 38 SSIs were detected (4.2%). The median length of stay (LOS) for surgical patients without SSI was 10.0 days (range, 1-19 days); for patients who developed SSI it was 30 days (range, 1-52 days; P < .001). The median LOS prior to surgery for patients without SSI was 1 day (range, 0-4 days); for patients who developed SSI it was 3 days (range, 0-7.5 days; P < .001). Among 30 possible risk factors studied, wound class, LOS prior to surgery, and central venous catheterization were independent predictors of SSI. Median durations of prophylactic antibiotic therapy were 4 days (range, 1-14 days) and 6 days (range, 1-16 days) in the 1999 and 2000 surveys, respectively.Conclusion:Surgical patients in Greek hospitals suffered higher rates of SSI than did surgical patients in other developed countries while prophylactic antibiotics were used excessively.

scholarly journals 1126. Variability in Antibiotic Use in Children’s Hospitals in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S400-S401
Author(s):  
Hannah Griffith ◽  
Keerti Dantuluri ◽  
Cary Thurm ◽  
Derek Williams ◽  
Ritu Banerjee ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Antibiotic Use ◽  
Surgical Patients ◽  
Hospitalized Children ◽  
Medical Patients ◽  
Broad Spectrum Antibiotic ◽  
Children's Hospitals ◽  
Children’S Hospitals ◽  
Median Hospital ◽  
Research Grant

Abstract Background Understanding patterns of inpatient antibiotic use is necessary to enhance appropriate use and minimize preventable harm at hospitals. Few studies have characterized antibiotic use in the inpatient setting in children. Methods We conducted a cross-sectional study in children admitted to 51 freestanding US children’s hospitals included in the Pediatric Health Information System (PHIS). Overall and broad-spectrum antibiotic use (see Table) were measured using charge data, and prevalence of use was assessed on a single day of each 2017–2018 season over one year. Comparisons were made based on clinical setting (medical vs. surgical), clinical unit (PICU, NICU, and all others), hospital, and region. We assessed the relationship between antibiotic use and median hospital case-mix index (CMI), a surrogate for clinical complexity. Results Of 52769 hospitalized children assessed on a study day, 19174 (36%) received antibiotics, and 6575 (12%) received broad-spectrum antibiotics (table). Overall antibiotic use prevalence varied across hospitals from 22% to 52% (Figure 1). Median hospital CMI had no significant relationship with overall antibiotic use and only a weak correlation (ρ=0.29) with broad-spectrum antibiotic use (Figure 2). Antibiotic use prevalence varied minimally by season, ranging from 36% in fall to 37% in summer. Antibiotic use prevalence was 29% (9470/32436) among medical patients and 48% (9704/20333) among surgical patients. The antibiotics most commonly administered in medical patients were ceftriaxone and ampicillin, while surgical patients most commonly received cefazolin and vancomycin. Regional prevalence ranged from 33% (Midwest) to 40% (West). By unit, PICU patients had the highest prevalence of overall [58% (4006/6874)] and broad-spectrum [27% (1830/6874)] antibiotic use. Children with complex chronic conditions accounted for 63% of hospitalized children but represented 72% of children receiving any antibiotic and 85% of those receiving broad-spectrum antibiotics. Conclusion We observed large and apparently unexplained variability in antibiotic use prevalence among children’s hospitals, clinical settings, and regions. This indicates potential opportunities for enhanced antibiotic stewardship activities. Disclosures Ritu Banerjee, MD, PhD, Accelerate Diagnostics: Grant/Research Support; BioFire: Research Grant; Biomerieux: Research Grant; Roche: Research Grant

scholarly journals 352 A Retrospective Audit to Determine the Appropriateness of Antibiotic Use in Surgical Patients in MKUH

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Stone ◽  
A Khanna ◽  
B Keeler
Keyword(s):  
Antibiotic Resistance ◽  
Hospital Admission ◽  
Wound Infection ◽  
Emergency Surgery ◽  
Antibiotic Stewardship ◽  
Renal Stones ◽  
Antibiotic Use ◽  
Surgical Patients ◽  
Clinical Settings ◽  
Retrospective Audit

Abstract Introduction This audit’s aim is to determine the appropriateness of antibiotics dispensed in Emergency Surgery Clinic (ESC) for a two-month period in 2020. Antibiotic stewardship promotes appropriate antibiotic use in clinical settings whilst limiting unnecessary use. Appropriate antibiotic use is important in reducing the risk of antibiotic resistance. Method We extracted the following details from 801 patients’ electronic notes who attended MKUH ESC: diagnosis, prescription of antibiotics, hospital admission, and re-attendance at the ESC. Prescriptions were analysed as to whether they were in accordance with our microbiology guidelines. Patients were analysed as a collective and within diagnosis sub-specialities (appendicitis, wound infection, gallstones/cholecystitis, testicular pathology, UTI, diverticulitis, renal stones and abscesses). Results 218 (27%) patients were given antibiotics, 180 (22%) patients re-attended ESC and 111 (14%) were admitted. Only 77 patients (35%) receiving antibiotics were prescribed appropriately. Outcomes also varied by diagnosis. All patients presenting with UTI (n = 15) were treated correctly. In contrast, only 71% of patients with renal stones (n = 68) were incorrectly treated with antibiotics. Conclusions Two-thirds of patients receiving antibiotics were inappropriately prescribed. This together with the variation by diagnosis would suggest further measures be introduced to support antibiotic stewardship and mitigate the risk of antibiotic resistance.

Antibiotic Overuse is a Major Risk Factor for Clostridium difficile Infection in Surgical Patients

2017 ◽  
Vol 38 (10) ◽  
pp. 1254-1257 ◽  
Author(s):  
James T. Bernatz ◽  
Nasia Safdar ◽  
Scott Hetzel ◽  
Paul A. Anderson
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Antibiotic Use ◽  
Morbidity And Mortality ◽  
Major Risk Factor ◽  
Surgical Patients ◽  
Antibiotic Overuse ◽  
The Past

Clostridium difficile infection (CDI) is associated with increased cost, morbidity, and mortality in postoperative patients. Variable rates of postoperative CDI are reported among 4 surgical specialties during the 30-month study period. Risk factors for CDI include antibiotic use, increased ASA score, and increased admissions in the past year.Infect Control Hosp Epidemiol 2017;38:1254–1257

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