EVALUATION OF THE PRACTICE OF THE ANTIBIOTIC PROPHYLAXIS IN EMERGENCY SURGERY

Mohamed Réda Sefrioui*, Hicham Fettah, Félicité Xavière Ouango Wen-Dangare, Yahia Cherrah, Adnane Benmoussa and Soufiane Derraji

ABSTRACT

Background: The objective of this work was to evaluate the compliance of the practices of surgical antibioprophylaxis in the emergency operating room of the Military Teaching Hospital Mohamed V of Rabat. In the absence of a local protocol, the reference system was the consensus conference of the French Society of Anesthesia and Resuscitation (SFAR) updated in 2010. Method: This is a prospective, descriptive and analytical study of the practice of surgical antibiotic prophylaxis, which involved 257 patients operated on an emergency basis between March and June. The data were collected using a data sheet. Exploitation and analysis by the SPSS software from the anesthesiology file. The conformity of the prescriptions is evaluated by comparison with the reference system of SFAR 2010 and the criteria of judgment established by the High Authority of Health. Results and Discussions: Of all patients, 16 were excluded from the study because of documented antibiotic therapy. The 241 patients included fall into two populations that have been studied separately. The outpatient population at the hospital, 226 patients, received antibiotic prophylaxis as recommended by SFAR of the patients, 6.2% benefited from the practice of appropriate antibiotic prophylaxis. The compliance of each of these criteria was 85% for the indication, 54.5% for the choice of the molecule, 77.9% for the dosage, 7.1% for the incision period, 79.2% for the duration of the prophylaxis, 1.8% for reinjection rhythms and 8.4% for surgical site infections. Overall compliance is unsatisfactory. It is linked to the non-respect of the criterion of the incision period. The internal hospital population is 15 patients. These patients had benefited from probiotic antibiotherapy perioperatively often with the use of Cefazoline (46.6%) or the combination Amoxicillin / Clavulanic acid (40%), while already under curative treatment. Conclusion: Significant efforts need to be made by sensitizing and mobilizing anesthetists, doctors and pharmacists. The use of probabilistic prescription of antibiotics must be completely limited because of a risk of reinfection despite the use of these antibiotics perioperatively.

Keywords: Antimicrobial prophylaxis – Surgical wound infections – Emergency.