Cerrahi antibiyotik profilaksisi ve üçüncü basamak eğitim hastanesinde akut apendektomide standart tedavi kılavuzlarına uyulması

Amaç: Bu çalışma akut apendektomide cerrahi antibiyotik profilaksisinin (SAP) rasyonel kullanımını araştırmak için yapıldı. Gereç ve Yöntem: Bu araştırma, eğitim hastanesinde (Pakistan) altı aylık çalışma süresi boyunca akut apendektomi yapılan 400 hastanın reçetesini prospektif olarak analiz etti. SAP'nin ödenekleri Amerikan Cerrahlar Koleji ve Amerikan Sağlık Sistemi Eczacıları Birliği (ASHP) kurallarına göre değerlendirildi. Antibiyotik kullanımı için Dünya Sağlık Örgütü Anatomik Tedavi Kimyasal (ATC) metodolojisini de kullandı. Bulgular: Bu hastaların yaş ortalaması 28 idi (IQR = 16-45; SD = 8.5). Bunlardan% 37,3'ü doğru seçim, doz için% 100, rota için%100 ve antibiyotik zamanlaması için%49,5 (optimal değer%100) ile ilgili kurallara göre yapışmıştır. Sık ve uygunsuz olarak reçete edilen antibiyotik seftriaksondu. SAP'nin kombinasyon kullanımı da rapor edildi. Sonuç: Uygun olmayan seçim, antibiyotiklerin zamanlaması ve yanlış kullanımı bu çalışmada bildirilen başlıca problemlerdir.

Anahtar Kelimeler:

Acute appendicitis, antibiotic guidelines, surgical prophylaxis

Surgical antibiotic prophylaxis and compliance with the standard treatment guidelines in acute appendectomy at tertiary care teaching hospital

Purpose: This study was conducted to investigate the rational use of surgical antibiotic prophylaxis (SAP) in acute appendectomy. Materials and Methods: This research analyzed prospectively prescriptions of 400 patients who underwent acute appendectomy during six months study period at teaching hospital (Pakistan). Appropriates of SAP was evaluated according to American College of Surgeons and American Society of Health-System Pharmacists (ASHP) guidelines. The World Health Organization recommended Anatomical Therapeutic Chemical (ATC) methodology was also used for antibiotic utilization. Result: Mean age of these patients was 28 years (IQR = 16-45; SD=8.5) years with majority of male patients (60%). Out of these, 37.3% adhered according to guidelines with respect to correct choice, 100% for dose, 100% for route and 49.5% for timing of antibiotic (optimal value 100%). The commonly and inappropriately prescribed antibiotic was ceftriaxone. Combination use of SAP was also reported. Conclusion: Inappropriate choice, timing and misuse of antibiotics are main reported problems in this study.

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