ANTIBIOTIC UTILIZATION AND PROPHYLAXIS STUDIES IN PEDIATRIC CARDIAC SURGERY IN A RURAL TERTIARY CARE HOSPITAL IN INDIA
Sohilkhan Riyazkhan Pathan* and Dr. Amit Kumar
The present study was conducted to assess the antibiotic utilization and prophylaxis pattern in patients of pediatric cardiac surgery. An observational retrospective study was conducted on 100 pediatric patients who had undergone cardiac surgery in 2017-18. All the data of the patients was received from the medical record department of the Shree Krishna hospital, a tertiary care hospital in rural area, in the state of Gujarat, India. After collecting all the data Descriptive statistic were used to depict profile of study participant and pattern of antibiotic usage. The use of antibiotic prophylaxis in pediatric cardiac surgery in the study group was 100%. In our study we found that 30% patients were started antibiotic before the day of surgery. Out of these patients 30% patients did not need antibiotics as per the institute protocol. Out of 100 patients 87% patients got first line drug as hospitals policy for prophylaxis (cefoperazone and sulbactam + Amikacin), 9% patients got drug piperacillin/tazobactam + Amikacin as they were septic. On base of clinical record and pre-operative investigations 22% patients were given these drugs irrationally. Another 4% patients got piperacillin/tazobactam + teicoplanin. In the last group one had received the higher antibiotics irrationally. Only 27% patients have had an appropriate duration of prophylaxis use. On further evaluation it was found that 40% patients received prophylaxis for more than 48 hours inappropriately. It implies that prolonged use of antibiotics was highly prevalent in our study group. Of the 100 patients, 45 patients were prescribed antibiotics at hospital discharge, again a high number. Out of these 45 patients, 73% patients had given Antibiotics rationally and 27% patients had given antibiotics irrationally. This study gives an important insight of antibiotics misuse in Pediatric cardiac surgical patients and more stringent measures are required to limit & curtail excessive use of antibiotics.
Keywords: Antibiotic Prophylaxis, Pediatric Cardiac Surgery.
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