Current Trend of Antibiotic Practice in Paediatric Surgery in Bangladesh
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Introduction: Antibiotics, major life saving agents are frequently over prescribed. The extent and pattern of inappropriate use is well documented in developed countries but such studies are few in developing countries like Bangladesh. Objective: To find out current trend of antibiotic practice in Paediatric Surgery in Bangladesh Methodology: This cross sectional descriptive study was carried out on 300 paediatric patients of 0-15 years age range, to find out the pattern of antibiotic practice in three major pediatric practicing hospitals of Dhaka, Bangladesh. All the patients were studied after categorization into i) Clean ii) Clean-contaminated iii) Contaminated and iv) Dirty wounds according to their potentiality of post operative wound infection. Total period of antibiotic practice was divided into a. Pre-operative (Up to the day before operation) b. Per-operative (during or just before operation) c. Post-operative (days after operation) and d. Post-discharge stage for the convenience of this study. Antibiotic practice in all categories during all periods mentioned were compared and evaluated. Results: More than two antibiotics were given in a single patient in 38.5% of clean and 62.8% of contaminated patients in a combination or sequentially. More than 3 antibiotics were used in a single patient in 46.9% and 80% of contaminated and dirty categories. Overall 65.7%, 72.30%, 96.3% and 88.3% patients received antibiotics in pre-operative, per-operative, post-operative and post-discharge stage respectively. Maximum (82%) preoperative antibiotics were used in dirty and minimum (53.3%) in clean category. Maximum (76.3%) per-operative antibiotics were given clean and minimum (55%) in dirty category. More than 94% of all categories received postoperative antibiotics. More than 81% patients in each category of patients were prescribed antibiotics during discharge. Mean of total duration of antibiotic use was more than 16 days in all the categories of patients. Longest mean duration of antibiotic use was (20±11.60) found in Clean-contaminated and shortest (17.40±9.44) in dirty categories. The mean duration of post discharge advice of antibiotics in different categories was more than (6.33+2.50) days. Overall 65.7% patient received preoperative antibiotics. Minimum (53.3%) use seen in clean and maximum (82.5%) in dirty category. On the average 72.30% patients received per-operative antibiotics. Maximum (76.3%) per-operative use was seen in clean and minimum (55%) in dirty category. Overall 96.30% of patients received post-operative antibiotics including all the patients of clean-contaminated category. More than 80% patients in each group received antibiotic after discharge. No significant difference is found in post-operative and post-discharge antibiotics use among the groups (P>0.1ns). Conclusion: Antibiotic overuse is generalized and not categorized according to the categories of surgical wounds.
Authors and Affiliations
Dr. AKM Shamsuddin, Dr. Malik Saifor Rahman, Dr. Nasrin Sultana, Dr. Mohammad Saiful Islam, Dr. Asit Kumar Shaha, Mohammad Reazaul Karim, Dr. Dipak Chondra Kirttaniya
Keywords
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- EP ID EP572747
- DOI 10.9790/0853-1804082832.
- Views 73
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