Abstract
Background: Surgical Site Infections (SSIs) are significant complications of orthopedic surgeries and lead to a longer stay in the hospital, high healthcare expenses, and antimicrobial resistance. Postoperative infections can be successfully prevented by appropriate use of surgical antibiotic prophylaxis (SAP); nevertheless, irrational use of antibiotics is still widespread in clinical practice.
Objectives: To assess the trend of antibiotic use, compliance with hospital antibiotic policies and antimicrobial resistance trends in orthopedic surgery patients in the tertiary care hospitals in Lahore, Pakistan.
Methods: A prospective cross-sectional observational study was conducted among 188 orthopedic surgical patients in five tertiary care hospitals. A structured form was used to collect data through patient records, the operative notes, medication charts and laboratory reports. The use of antibiotics was evaluated in terms of selection, number, dose, route, frequency, and duration. Hospital antibiotic policies and microbiological data were also reviewed. The statistical analysis was done using SPSS version 26 with p < 0.05 regarded as significant.
Results: Cefoperazone + Sulbactam were the most commonly used antibiotics. Combination therapy was most common, with 59.6% of the patients receiving three antibiotics, while only 5.3% received single antibiotic therapy. Intravenous administration and twice daily dosing were the most frequently observed practices. There was high compliance with the policy, although only 1.6% of samples were subjected to culture testing. Only one patient (0.5%) developed an infection with antibiotic resistance. Statistically significant associations were found between patient age, type of surgical procedure and number of prescribed antibiotics (p = 0.027).
Conclusion: Routine use of multiple broad-spectrum antibiotics without adequate culture and sensitivity testing should be avoided.
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