Study on Practice of Antibiotic Prophylaxis in Cesarean Section in Two Hospitals of Kathmandu Valley

Background: The potential for the prophylactic antibiotics to reduce maternal morbidity after cesarean section is well established. But the inappropriateness of the antibiotic prophylaxis is still a worldwide problem. There is variation in the dose regimen and duration of prophylaxis. The main objec...

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Main Author:	Pokharel, A
Format:	Technical Report
Language:	en_US
Published:	2016
Subjects:	cesarean section postoperative infections prophylactic antibiotics prophylaxis utilization
Online Access:	http://103.69.126.140:8080/handle/123456789/250
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spelling	oai:103.69.126.140:123456789-2502022-11-08T10:29:32Z Study on Practice of Antibiotic Prophylaxis in Cesarean Section in Two Hospitals of Kathmandu Valley Health Care Delivery System Pokharel, A cesarean section postoperative infections prophylactic antibiotics prophylaxis utilization Background: The potential for the prophylactic antibiotics to reduce maternal morbidity after cesarean section is well established. But the inappropriateness of the antibiotic prophylaxis is still a worldwide problem. There is variation in the dose regimen and duration of prophylaxis. The main objective of this study was to compare the prophylactic antibiotic regimen used in two different hospitals of Kathmandu valley. Methods: A prospective follow up study was used to evaluate the patients undergoing cesarean section. Total of 100 patients, 50 each from Prasuti Griha and Tribhuwan University Teaching Hospital were taken for the study. The outcome measured were development of any postoperative complications: fever, urinary tract infection, wound infection, endometritis. Data on dose, duration and time of administration of prophylactic antibiotics were taken. Results: Prophylactic antibiotics were prescribed to all patients. But there was a practice variation of prophylaxis in both hospitals. Groups of antibiotics used for prophylaxis were fluroquinones and penicillin in Prasuti Griha and cephalosporins in Tribhuwan University Teaching Hospital. Though the single dose of antibiotic intraoperatively was sufficient as prophylaxix, the duration was longer in both hospitlas and administered postoperatively in 92% of cases. There was no significant difference in total duration of antibiotic therapy in Prasuti Griha and Tribhuwan University Teaching Hospital (6.8 vs.6.7; P>0.05). The proportions of development of postoperative complications in both hospitals were insignificant (P>0.05). There were no significant difference in the effectiveness of regimen measured in terms of postoperative complications (P=0.545). But the total cost of therapy of all regimens differ significantly (P=0.00) and also within the same hospitals (P<0.05). Conclusions: The practice of prophylactic antibiotics was inappropriate in both hospitals. They were prescribed unnecessarily for longer duration though single dose of prophylaxis was sufficient. Keywords: cesarean section; postoperative infections; prophylactic antibiotics; prophylaxis; utilization. 2016-11-08T13:38:22Z 2022-11-08T10:11:38Z 2016-11-08T13:38:22Z 2022-11-08T10:11:38Z 2003 Technical Report http://103.69.126.140:8080/handle/123456789/250 en_US application/vnd.openxmlformats-officedocument.wordprocessingml.document
institution	My University
collection	DSpace
language	en_US
topic	cesarean section postoperative infections prophylactic antibiotics prophylaxis utilization
spellingShingle	cesarean section postoperative infections prophylactic antibiotics prophylaxis utilization Pokharel, A Study on Practice of Antibiotic Prophylaxis in Cesarean Section in Two Hospitals of Kathmandu Valley
description	Background: The potential for the prophylactic antibiotics to reduce maternal morbidity after cesarean section is well established. But the inappropriateness of the antibiotic prophylaxis is still a worldwide problem. There is variation in the dose regimen and duration of prophylaxis. The main objective of this study was to compare the prophylactic antibiotic regimen used in two different hospitals of Kathmandu valley. Methods: A prospective follow up study was used to evaluate the patients undergoing cesarean section. Total of 100 patients, 50 each from Prasuti Griha and Tribhuwan University Teaching Hospital were taken for the study. The outcome measured were development of any postoperative complications: fever, urinary tract infection, wound infection, endometritis. Data on dose, duration and time of administration of prophylactic antibiotics were taken. Results: Prophylactic antibiotics were prescribed to all patients. But there was a practice variation of prophylaxis in both hospitals. Groups of antibiotics used for prophylaxis were fluroquinones and penicillin in Prasuti Griha and cephalosporins in Tribhuwan University Teaching Hospital. Though the single dose of antibiotic intraoperatively was sufficient as prophylaxix, the duration was longer in both hospitlas and administered postoperatively in 92% of cases. There was no significant difference in total duration of antibiotic therapy in Prasuti Griha and Tribhuwan University Teaching Hospital (6.8 vs.6.7; P>0.05). The proportions of development of postoperative complications in both hospitals were insignificant (P>0.05). There were no significant difference in the effectiveness of regimen measured in terms of postoperative complications (P=0.545). But the total cost of therapy of all regimens differ significantly (P=0.00) and also within the same hospitals (P<0.05). Conclusions: The practice of prophylactic antibiotics was inappropriate in both hospitals. They were prescribed unnecessarily for longer duration though single dose of prophylaxis was sufficient. Keywords: cesarean section; postoperative infections; prophylactic antibiotics; prophylaxis; utilization.
format	Technical Report
author	Pokharel, A
author_facet	Pokharel, A
author_sort	Pokharel, A
title	Study on Practice of Antibiotic Prophylaxis in Cesarean Section in Two Hospitals of Kathmandu Valley
title_short	Study on Practice of Antibiotic Prophylaxis in Cesarean Section in Two Hospitals of Kathmandu Valley
title_full	Study on Practice of Antibiotic Prophylaxis in Cesarean Section in Two Hospitals of Kathmandu Valley
title_fullStr	Study on Practice of Antibiotic Prophylaxis in Cesarean Section in Two Hospitals of Kathmandu Valley
title_full_unstemmed	Study on Practice of Antibiotic Prophylaxis in Cesarean Section in Two Hospitals of Kathmandu Valley
title_sort	study on practice of antibiotic prophylaxis in cesarean section in two hospitals of kathmandu valley
publishDate	2016
url	http://103.69.126.140:8080/handle/123456789/250
work_keys_str_mv	AT pokharela studyonpracticeofantibioticprophylaxisincesareansectionintwohospitalsofkathmanduvalley AT pokharela healthcaredeliverysystem
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Study on Practice of Antibiotic Prophylaxis in Cesarean Section in Two Hospitals of Kathmandu Valley

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