scholarly journals An audit of antibiotic usage in surgical prophylaxis: a prospective observational study in the surgical ward of german orthopaedic hospital in bahrain

2020 ◽  
Vol 13 (2) ◽  
pp. 350-351
Author(s):  
D. Ebrahim Hussain Habib Ahmed
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Antibiotic Usage ◽  
Surgical Prophylaxis ◽  
Orthopaedic Hospital ◽  
Surgical Ward

Antimicrobial Use in Outpatient Hemodialysis Units

2013 ◽  
Vol 34 (4) ◽  
pp. 349-357 ◽  
Author(s):  
Graham M. Snyder ◽  
Priti R. Patel ◽  
Alexander J. Kallen ◽  
James A. Strom ◽  
J. Kevin Tucker ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Observational Study ◽  
Prospective Study ◽  
Prospective Observational Study ◽  
Chronic Hemodialysis ◽  
Fourth Generation ◽  
Antimicrobial Use ◽  
National Guidelines ◽  
Surgical Prophylaxis ◽  
Narrow Spectrum

Objective.To quantify and characterize overall antimicrobial use, including appropriateness of indication, among patients receiving chronic hemodialysis.Design.Retrospective and prospective observational study.Setting.Two outpatient hemodialysis units.Patients.All patients receiving chronic hemodialysis.Methods.The rate of parenteral antimicrobial use (number of doses per 100 patient-months) was calculated retrospectively from September 2008 through July 2011. Indication and appropriateness of antimicrobial doses were characterized prospectively from August 2010 through July 2011. Inappropriate administration was defined as occasions when criteria for infection based on national guidelines were not met, failure to choose a more narrow-spectrum antimicrobial on the basis of culture data, or occasions when indications for surgical prophylaxis were not met.Results.Over the 35-month retrospective study period, the rate of parenteral antimicrobial use was 32.9 doses per 100 patient-months. Vancomycin was the most commonly prescribed antimicrobial, followed by cefazolin and third- or fourth-generation cephalosporins. Over the 12-month prospective study, 1,003 antimicrobial doses were prescribed. Among the 926 (92.3%) doses for which an indication for administration was available, 276 (29.8%) were classified as inappropriate. Of these, a total of 146 (52.9%) did not meet criteria for infection, 74 (26.8%) represented failure to choose a more narrow-spectrum antimicrobial, and 56 (20.3%) did not meet criteria for surgical prophylaxis. The most common inappropriately prescribed antimicrobials were vancomycin and third- or fourth- generation cephalosporins.Conclusions.Parenteral antimicrobial use was extensive, and as much as one-third was categorized as inappropriate. The findings of this study provide novel information toward minimizing inappropriate antimicrobial use.

scholarly journals The Value of Modified Early Warning Score (MEWS) in Surgical In-Patients: A Prospective Observational Study

2006 ◽  
Vol 88 (6) ◽  
pp. 571-575 ◽  
Author(s):  
J Gardner-Thorpe ◽  
N Love ◽  
J Wrightson ◽  
S Walsh ◽  
N Keeling
Keyword(s):  
Risk Management ◽  
Observational Study ◽  
Critically Ill ◽  
Early Warning ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Early Warning Score ◽  
Management Tool ◽  
Quality And Safety ◽  
Surgical Ward

INTRODUCTION The Modified Early Warning Score (MEWS) is a simple, physiological score that may allow improvement in the quality and safety of management provided to surgical ward patients. The primary purpose is to prevent delay in intervention or transfer of critically ill patients. PATIENTS AND METHODS A total of 334 consecutive ward patients were prospectively studied. MEWS were recorded on all patients and the primary end-point was transfer to ITU or HDU. RESULTS Fifty-seven (17%) ward patients triggered the call-out algorithm by scoring four or more on MEWS. Emergency patients were more likely to trigger the system than elective patients. Sixteen (5% of the total) patients were admitted to the ITU or HDU. MEWS with a threshold of four or more was 75% sensitive and 83% specific for patients who required transfer to ITU or HDU. CONCLUSIONS The MEWS in association with a call-out algorithm is a useful and appropriate risk-management tool that should be implemented for all surgical in-patients.

scholarly journals Risk factors of thrombophlebitis at infusion sites in patients admitted in surgical ward: a prospective observational study

2018 ◽  
Vol 5 (5) ◽  
pp. 1781 ◽  
Author(s):  
Atul Kumar Singh ◽  
Rajeev Dwivedi ◽  
A. P. S. Ghaharwar
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Burden Of Disease ◽  
Prospective Observational Study ◽  
Causative Factor ◽  
Postoperative Recovery ◽  
Age Group ◽  
Infusion Site ◽  
Medical College ◽  
Surgical Ward

Background: Peripheral venous canualation is indispensable in admitted patients in surgical ward, thrombophlebitis following infusion is seldom serious, but it effects on postoperative recovery, hospital stay and hence burden of disease are magnanimous. The main aim and objective of the study to find out the incidence of thrombophlebitis at the intravenous infusion site in surgical ward.Methods: This prospective observational study was conducted on 300 patients admitted in surgical ward of S.S Medical College and associated S.G.M. hospital, Rewa (M.P.) patients selected randomly. These Patients were visited daily for any sign and symptoms at infusion site. The incidence of thrombophlebitis according to age, sex and duration of infusion were recorded. The tool designed to collect the data were socio demographic performa and observational check list.Results: In total 300 patients the incidence of thrombophlebits is highest in age group of 41-50(20%), Male (64.66%) and incidence increases as the duration of infusion increased it is 100% after 5 days. The incidence of Grade -1 thrmbophlebitis (71.33%) is higher as compared to Grade- 2 (22.67%).Conclusions: Thrombophelebitis is still an important ongoing problem in admitted patients in surgical ward. Incidence of grade-I thrombophlebitis is higher. It is more in male in the age group of 40-50 and duration of infusion is main causative factor for development of thrombophlebitis.

scholarly journals Antibiotic usage in surgical prophylaxis: a prospective surveillance of surgical wards at a tertiary hospital in Malaysia

2014 ◽  
Vol 8 (02) ◽  
pp. 193-201 ◽  
Author(s):  
Ai Ling Oh ◽  
Leh Min Goh ◽  
Nik Abdullah Nik Azim ◽  
Chee Sian Tee ◽  
Chee Wei Shehab Phung
Keyword(s):  
Healthcare Costs ◽  
Prospective Observational Study ◽  
Tertiary Hospital ◽  
Antibiotic Usage ◽  
Prophylactic Antibiotics ◽  
Adherence Rate ◽  
Prospective Surveillance ◽  
Surgical Prophylaxis ◽  
Inappropriate Use ◽  
Clean Contaminated

Introduction: The widespread and inappropriate use of broad-spectrum antibiotics in surgical prophylaxis has led to reduced treatment efficacy, increased healthcare costs, and antibiotic resistance. This study aimed to explore the adherence of antibiotic usage in surgical prophylaxis to the national antibiotic guideline and the incidences of surgical site infection (SSI). Methodology: A three-month prospective observational study has been conducted in the surgical wards of Sarawak General Hospital (SGH) using a standardized surveillance form. Each patient was reviewed for up to 30 days post-operatively to determine the occurrence of SSI. Results: A total of 87 patients were included within the study period. The majority of the cases were clean-contaminated wounds (60.9%). Most were hepatobiliary cases (37.9%), followed by colorectal cases (19.5%). The most preferred antibiotic used was cefoperazone (63.2%). The choices of antibiotics in 78.2% of the cases were consistent with the guideline. Around 80% of prophylactic antibiotics were given within one hour before operation and 27.6% were omitted from intraoperative re-dosing. Prophylactic antibiotics were discontinued within 24 hours post-operatively in 77% of the cases. Of those continued for > 24 hours, the majority (60%) were administered for unknown reasons. SSI was documented in 13.8% of the total cases studied. However, there was no significant association between choices of antibiotics and timing of surgical prophylaxis with SSI (p = 0.299 and p = 0.258 respectively). Conclusion: Overall guideline adherence rate was more than 70%. Areas of non-concordance to the guideline require further investigation..

scholarly journals Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the surgical ward: a prospective observational study

2020 ◽  
Author(s):  
Maya Kanno ◽  
Mana Doi ◽  
Kazumi Kubota ◽  
Yuka Kanoya
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Older Patients ◽  
Postoperative Delirium ◽  
Prospective Observational Study ◽  
Physical Restraint ◽  
Assessment Method ◽  
Subsyndromal Delirium ◽  
Laboratory Test Results ◽  
Surgical Ward

Abstract Background: Postoperative delirium (POD) among older patients is a common, serious disease and is associated with a high incidence of negative outcomes. For early detection of POD and subsyndromal delirium (SSD), this study was conducted to identify risk factors of POD and SSD in older patients who were scheduled for surgery in a surgical ward.Methods: This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the surgical ward between April and September 2019. Both POD and SSD were assessed by using the Confusion Assessment Method (CAM) on the preoperative day, the day of surgery, and postoperative days 1–3 by the surgical ward nurses. SSD was defined as the presence of one or more CAM criteria and the absence of a diagnosis of delirium based on the CAM algorithm. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of physical restraint were collected from medical records. Logistic regression analyses were conducted to identify the risk factors for POD and SSD.Results: A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD and SSD. The use of bed sensors (odds ratio 10.2, p=.001) were identified as risk factors for POD and SSD.Conclusions: Our study shows that the use of bed sensors might be related to the development of POD and SSD among older patients in surgical wards.

Adverse reactions to two intravenous antibiotics (Augmentin and Zinacef) used for surgical prophylaxis in dogs

2017 ◽  
Vol 182 (3) ◽  
pp. 80-80 ◽  
Author(s):  
Mark James Gosling ◽  
Fernando Martínez-Taboada
Keyword(s):  
Adverse Effects ◽  
Adverse Events ◽  
Observational Study ◽  
Surgical Procedures ◽  
Clinical Setting ◽  
Prospective Observational Study ◽  
Adverse Reactions ◽  
Surgical Prophylaxis ◽  
System A ◽  
Intravenous Antibiotics

Antibiotic prophylaxis in dogs undergoing surgical procedures frequently involves the administration of a product without a veterinary licence. Two drugs commonly used for this purpose are the clavulanate amoxicillin Augmentin and the cefuroxime Zinacef. This prospective observational study aims to compare the incidence of adverse events associated with these two antibiotics in a clinical setting. The authors hypothesised that a higher incidence of adverse effects would be observed with Augmentin. Sixty-five dogs were included in the study and adverse events were recorded using a modified scoring system. A significantly higher incidence of adverse events to Augmentin (8/22; 36 per cent) was observed compared with Zinacef (1/43; 2 per cent) (P=0.0003). The majority of these adverse events involved cutaneous signs and/or hypotension. These findings might be taken into consideration when selecting one of these intravenous antibiotics for prophylaxis in anaesthetised dogs undergoing surgery.

scholarly journals PROSPECTIVE OBSERVATIONAL STUDY ON ANTIBIOTIC-PRESCRIBING PATTERN AND MEDICATION ERRORS IN SURGICAL PROPHYLAXIS IN A SPECIALTY HOSPITAL

2019 ◽  
pp. 47-50
Author(s):  
SENTHIL KUMAR N ◽  
SIVASAKTHI K ◽  
JISA ELIZABETH JOSEPH ◽  
VISHNUKUMAR VA ◽  
GEOLIN RP
Keyword(s):  
Observational Study ◽  
Sample Size ◽  
Medication Errors ◽  
Prospective Observational Study ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Surgical Prophylaxis ◽  
Prescribing Pattern ◽  
Antibiotic Drug ◽  
Specialty Hospital

Objective: The objective was to study the antibiotic-prescribing patterns, identify the medication errors and impact of surgical antimicrobial prophylaxis (SAP) in preventing surgical site infection (SSI), and to understand the prescribers’ adherence to surgical prophylaxis guidelines. Methods: The study was conducted for a period of 6 months in all surgical departments of a specialty hospital. Data were collected from inpatients records. Australian guideline for SAP was used to assess the appropriateness in prescribing pattern. The sample size was calculated using Raosoft sample size calculator. Results: A prospective observational study was carried out among 178 patients. Of which, 100 were male and 78 were female. Four hundred and thirty-three antimicrobials were prescribed as pre- and post-operative surgical prophylaxis, among that 87% prescribed by brand name and 13% by generic. Seventy-one percent received single antimicrobial agent preoperatively, of which 99.5% prescribed as parenteral and 0.5% as oral formulation. Most often prescribed antibiotic was cefoperazone (28%) of cephalosporin group. Only 5.6% of cases had compliance with SAP guidelines. In this study, 11 patients affected with SSI due to inappropriate antibiotic selection and non-adherence to prophylactic antibiotic guidelines. Conclusion: The present study revealed that there is a poor compliance to SAP guidelines in terms of inappropriateness in antibiotic drug selection, dose, duration, and omission of drugs. Inappropriateness and non-compliance are mainly due to unavailability of clinical pharmacist to assist the physicians in the selection and administration of correct choice of prophylactic drug and unavailability of proper national or local guidelines. Hence, there is dire need to make local SAP guidelines to improve SAP-prescribing pattern.

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