Study on Risk Factors and Antibiotic Use Pattern in Surgical Site Infections

Abstract

Surgical Site Infection (SSI) has an enormous impact on patients' quality of life and contributes significantly to the financial cost of patient care. The study was conducted to find how the risk factors influence the rate of SSI and to know about the use pattern of antibiotics in the management of SSI. In the study, data of 100 surgical patients were collected from two different hospitals namely Gonoshasthaya Nagar Hospital, Dhaka (GSNH) and Sher-E-Bangla Medical College Hospital, Barishal (SMCH). The study population consisted of 38% male and 61% female. The analysis done by SPSS 13, found that the maximum frequency of surgical patients was within the age of 40-45 for both male and female patients. Overall rate of SSI was found to be 13% in 100 patients. Individually, 9.7% surgical patients of GSNH and 18.4% of SMCH had SSI. Nearly 6% of the total patients had diabetes mellitus. About 50% of them developed SSI. The rate was 11.24% for those who did not have diabetes mellitus. Out of 100 patients, 12 patients had coexisting infection and rate of SSI with coexisting infection was 33.3%. Rate of infection increased with the order of wound class being highest 42.9% at ‘Contaminated’ class. Almost similar trend of 43% SSI rate was found in case of ASA Score 3. On average, patients in SMCH stayed for 2 times longer duration than GSNH patients. 21% surgical patients were given Ciprofloxacin as prophylaxis. In 19% cases Cefuroxime was used. In combination form, Ciprofloxacin and Metronidazole were given to 27% patients. Ciprofloxacin prevented the development of SSI for 92% surgical patients. Therefore, the study showed that Ciprofloxacin was the most effective antibiotic in SSI management; SSI rate was higher for the patients with Diabetes Mellitus than those who did not have it and longer duration of hospitalization in SMCH increased the SSI rate than the patients at GSNH. This study emphasized on antibiotic used and risk factors associated with SSI. However further study on etiological agents is suggested which may be required for making precise selection of antibiotics.