Usage of prophylactic antibiotics in uncomplicated gynecologic abdominal surgery in Siriraj Hospital

Abstract

Objective: To determine the rate of prophylactic antibiotics usage in uncomplicated gynecologic abdominal surgery in Siriraj Hospital, before and after guideline implementation. Material and Method: Two hundred and fifty-eight women who underwent elective gynecologic surgery for a benign condition were enrolled. The patients were divided into two groups, before and after guideline implementation (control and study group). Medical records of these women were reviewed to determine the rate of prophylactic antibiotics usage, rate of postoperative infection, and antibiotics cost. Results: The most common prophylactic antibiotics used were Cefazolin (41.9%), Cefoxitin (36.4%), and Augmentin (9.7%). Rate of single dose of cefazolin usage were not significantly different between the two groups (10.1% and 12.4% respectively, p = 0.482). However, the rate of postoperative oral antibiotic usage was significantly decreased (31.8% and 14.7% respectively, p = 0.001). The reduction of oral antibiotic usage was significant among staff only. The rate of postoperative infection between control and study groups, as well as between single and other antibiotic prophylaxis were similar. Had a single dose of cefazolin been administered to all patients, the antibiotics cost would have been reduced by 102,012 Baht or 91.8%. Conclusion: Rate of a single dose of cefazolin usage as antibiotic prophylaxis in gynecologic surgery was similar to before guideline implementation. However, postoperative oral antibiotics usage decreased significantly, especially among the staff.