Hussein, Maiga Ayub
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Antibiotic Practices and The Rate of Surgical Site Infection Following Cesarean Section Hussein, Maiga Ayub; Sutiningsih, Dwi; Saidi, Ntambi; Frida, Chebet; Adi, Mateus Sakundarno
Jurnal Epidemiologi Kesehatan Komunitas Vol 9, No 2 : Agustus 2024
Publisher : Master of Epidemiology, Faculty of Public Health, Diponegoro University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jekk.v9i2.18878

Abstract

Background: Cesarean section (CS) is the most performed operation globally. It’s a clean-contaminated surgery with higher surgical site infections (SSIs) risk. The mortality rate associated with cesarean section in Africa is 50 times greater than in high income settings, 11 women die per 1000 CS in sub-Saharan Africa and 14% of women suffer complication (SSIs). Proper antibiotic use can reduce this burden however effective antibiotics are running out due to inappropriate use. This study aimed to assess the pre-cesarean and post-cesarean antibiotic practices and the rate of SSIs following CS at Mbale regional referral hospital (MRRH)Methods: The study was a retrospective and descriptive cross-sectional on CS mothers between 1st January 2020 and 31st December 2022 at MRRH.  Out of the 2432 patient files reviewed, an equal number (104) of women who developed SSIs and those that did not develop SSIs (104) were selected by simple random sampling, total sample size of 208.Result: More than half (n=148; 71.2 %.) received antibiotic prophylaxis. Majority received I.V ceftriaxone (38.0%) within 15minutes (mean duration) before skin incision. 35.1% of 208 that received antibiotic prophylaxis developed SSIs. I.V Metronidazole and Ceftriaxone were the most administered after CS and Oral metronidazole was the most prescribed upon discharge.Conclusion : The rate of SSIs at MRRH was 3% similar to that of Mbarara regional referral hospital at 3.5%. Lack of antibiotics prophylaxis and poor antibiotic prophylaxix timing could explain this rateu underscoring compliance to International, National and Hospital surgical bundles.
The Prevalence and The Association of Antibiotic Practices with Surgical Site Infection Following Cesarean Section Hussein, Maiga Ayub; Sutiningsih, Dwi; Ntambi, Saidi; Frida, Chebet
Jurnal Epidemiologi Kesehatan Komunitas Vol 9, No 1 : Februari 2024
Publisher : Master of Epidemiology, Faculty of Public Health, Diponegoro University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jekk.v9i1.19423

Abstract

Background: This study focuses on Cesarean section (CS) procedures and the associated risk of surgical site infections (SSIs). The global CS rate is currently at 21%, higher than the recommended 15%, leading to an increased risk of SSIs. These infections are a significant burden on economies, healthcare systems, patients, and their families, despite being preventable. The research aims to address the issue in Uganda, where the burden of SSIs stands at 15.5%. While previous studies have examined various risk factors, such as age, parity, surgeon expertise, and antiseptic solutions, there is a lack of research on pre- and post-CS antibiotic practices and their connection to SSIs. This study seeks to establish the prevalence of SSIs and evaluate the antibiotic practices before and after CS procedures at Mbale Regional Referral Hospital from January 1, 2020, to December 31, 2022.Methods: The design was retrospective cross-sectional. Consecutively selected 104 patient files that developed SSIs and randomly an equal number of patient files that did not develop SSIs to make up a sample size of 208 files that were reviewed at Mbale regional referral hospital (MRRH) from 1st –January -2020 to 31st -December-2022.Result: The prevalence of surgical site infections (SSIs) was 4.3%. Among the 208 patient files reviewed, 71.2% received antibiotic prophylaxis, with intravenous ceftriaxone being the most common (47.1%). However, only 14.9% received prophylaxis within the recommended 30-60 minutes before incision. Post-cesarean section, 92.8% received intravenous ceftriaxone and metronidazole, and the mean hospital stay was 2.74 days. Factors significantly associated with reduced SSI risk were the timing of antibiotic prophylaxis, administration of intravenous antibiotics post-cesarean, oral antibiotics post-cesarean, duration of hospital stay, and the cadre of the surgeonConclusion: The prevalence of surgical site infections (SSIs) at Mbale Regional Referral Hospital (MRRH) was found to be 4.3%. This study highlighted several factors that were associated with a reduced risk of SSIs in women undergoing Cesarean section (CS), including timely administration of antibiotic prophylaxis within 30-60 minutes before the incision, the use of post-CS intravenous (IV) ceftriaxone and metronidazole, hospital stays of 3 days, oral cefixime upon discharge, and being operated on by a medical officerRecommendation: The study emphasizes the importance of medical professionals following guidelines and acquiring knowledge on appropriate antibiotic use to combat surgical site infections (SSIs) following cesarean sections. Adhering to guidelines and continuous education is crucial in preventing SSIs and addressing antibiotic resistance