Surgical antimicrobial prophylaxis and its dose appropriateness among paediatric patients in a Nigerian teaching hospital

Surgical antimicrobial prophylaxis (SAP) prevents incision site infection. We assessed SAP compliance with existing international guidelines, evaluated the appropriateness of the antimicrobial doses, and determined the risk factors for antimicrobial under-dosing. A retrospective chart review was per...

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Bibliographic Details
Published in:Journal of chemotherapy (Florence) 2019-08, Vol.31 (6), p.329-342
Main Authors: Oshikoya, Kazeem Adeola, Ogunyinka, Ibrahim Abayomi, Adamaigbo, Comfort, Olowo-Okere, Ahmed
Format: Article
Language:English
Subjects:
Adolescent
Anti-Infective Agents - administration & dosage
Antimicrobial agents
Appropriateness
Child
Child, Preschool
Dose-Response Relationship, Drug
Doses
Female
Guideline Adherence - statistics & numerical data
Hospitals, Teaching
Humans
Infant
Infant, Newborn
Male
Nigeria
Paediatric
Prophylaxis
Retrospective Studies
Surgery
Surgical Wound Infection - prevention & control
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Summary:Surgical antimicrobial prophylaxis (SAP) prevents incision site infection. We assessed SAP compliance with existing international guidelines, evaluated the appropriateness of the antimicrobial doses, and determined the risk factors for antimicrobial under-dosing. A retrospective chart review was performed for patients who under-went surgery and administered antimicrobial prophylaxis. Compliance with SAP guidelines was evaluated. Antimicrobial doses were categorized as under-, normal-, or over-dose. Of the 303 surgical patients, 97.7% received SAP and complete compliance was achieved in 5.6%. Of the 550 antimicrobial prescriptions, metronidazole (42.7%) and cefuroxime (34.7%) were the most prescribed. Over- (31.5%), under- (44.5%), and normal- dosing (24.0%) were recorded, respectively. None of the factors evaluated predicted the risk of antimicrobial under-dosing. Full compliance with international SAP guidelines was poor in our study. Correct timing, re-dosing, and duration of antimicrobial use were the most violated. Most antimicrobials were under-dosed, suggesting a need for national and institutional SAP guidelines.
ISSN:1120-009X
1973-9478
DOI:10.1080/1120009X.2019.1615725