USE OF SURGICAL ANTIMICROBIAL PROPHYLAXIS AND MAGNITUDE OF SURGICAL SITE INFECTION AMONG SURGICAL PATIENTS AT HIWOT FANA HOSPITAL, HARAR, ETHIOPIA

Abstract

Background: Surgical antimicrobial prophylaxis is the use of antibiotics before, during, or after a surgical procedure to prevent surgical site infections which are defined as infections related to an operative procedure that occurs at or near the surgical incision. Objectives: To assess the use of surgical antimicrobial prophylaxis and magnitude of surgical site infection among patients who underwent a surgical procedure in Hiwot Fana Comprehensive Specialized Hospital, Harar, Ethiopia. Method: Hospital based Cross-Sectional study by review of randomly selected documents from November 1, 2022 – October 31, 2023 was used to analyze patients who underwent surgical procedures after admission with calculated sample size being 297. The data collected from patients’’ charts was analyzed by using SPSS version 26. Data were checked, cleaned for any deficit before entry. Descriptive analyses and bivariate and multivariate logistic regression analyses was done to examine the relationship between the outcome variable and predictors Results: Surgical antimicrobial prophylaxis was administered for 96 % of patients: ceftriaxone being the most frequently (72%) used single antimicrobial agent, with combination of ceftriaxone and metronidazole used in 68 patients (22.9%). The diagnosis of Surgical site infection was made in 32 patients (10.9 %) with 23 (7.74 %) having superficial type. Presence of comorbidity (AOR= 2.85, 95% CI: 1.07–7.56, p=0.03), history of previous surgery. (AOR 3.36; 95%CI : 1.08-10.4), Preoperative ASA score two and three .(AOR 4.89; 95%CI :1.72-13.7 ) and .(AOR 7.70; 95%CI : 1.80-32.8) respectively, emergency procedures (AOR= 3.14, 95% CI : 1.13-8.60, p=0.02) , . contaminated and dirty wound classes. (AOR 15.3; 95%CI: 2.66-88.9). and devoid of prophylactic antibiotics (AOR 5.88; 95%CI: 1.88-18.1) were significantly associated with development of Surgical site infection. Conclusion: The prevalence of Surgical site infection was moderate as compared to other Ethiopian studies with high rate of utilization of Surgical antimicrobial prophylaxis. Emergency Surgical procedures, presence of comorbidity, contaminated and Dirty wound classes and devoid of prophylactic antibiotics were significantly associated with surgical site infection.