Timing of prophylactic antibiotic administration in an orthopedic hospital in a developing country

• Main Authors: Adesina Ajibade, Oluwatoba Taiwo Akinniyi
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2013-01-01
• Series: Sahel Medical Journal
• Subjects: Perioperative prophylactic antibiotics; orthopedic practice; surgical site infections
• Online Access: http://www.smjonline.org/article.asp?issn=1118-8561;year=2013;volume=16;issue=4;spage=144;epage=147;aulast=Ajibade

Background: Appropriate timing of administration is crucial to the effectiveness of prophylactic antibiotics in preventing surgical site infection. Poor adherence to perioperative antibiotic prophylaxis recommendations has been documented from developed countries, but there is a paucity of data on this subject from Nigeria. The aim of this study was to assess the timeliness of administration of the first dose of prophylactic antibiotics in orthopedic surgery. Materials and Methods: In this observational study in an orthopedic practice, administration of antibiotics in operations done over a 6-month period was investigated. The main outcome measure was timing of antibiotic administration in relation to skin incision and tourniquet application. Optimum timing was defined as prophylactic antibiotic administration 15-60 min before skin incision or tourniquet application. Univariate analysis was performed using CDC-Epi Info TM Version 3.5.1 (August 2008). Results: There were 102 procedures out of which 95 (93.1%) were performed without a tourniquet. Of these 95 procedures, antibiotics were given before skin incision in 53 (55.8%) procedures and administration was optimum only in 16 (16.8%) procedures. The median induction-incision interval was 19 min (range: 3-45 min). Conclusion: Timing of perioperative antibiotic administration was inadequate. Routine administration at induction of anesthesia may promote optimum timing and can be considered as in any practice where no written perioperative antibiotic protocol exists.