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Surgical antimicrobial prophylaxis: Knowledge and compliance of guidelines among surgeons in a tertiary care teaching hospital

Introduction: Surgical antimicrobial prophylaxis (SAP) is considered vital for reducing surgical site infection, however, if inappropriate, it prolongs the hospital stay of patients, increases morbidity, promotes antimicrobial resistance and puts an economic burden on the health system. This study was carried out to assess the knowledge and compliance of SAP among surgeons in a hospital. Methods: A quantitative, non-interventional study was done among surgeons from a tertiary teaching hospital. First, we evaluated participant knowledge from different surgical specialities by the pre-designed questionnaire, and second, we audited surgeries during the study period of 3 months for a compliance rate of SAP. The score of responses and compliance to SAP variables during surgeries was studied. Results: We assessed a total of 184 participants for knowledge and 271 surgeries were audited. Among the variables of surgical prophylaxis, majority of the participants answered correctly about the route and timing of administration of SAP in 179 (97.3%) and 145 (78.8%) respectively. Only 66 (35.9%) knew about the correct choice of SAP while 78 (42.4%) responded correctly about the duration within which it should be stopped. However, two-third 138 (75%) were aware of the assessment of beta-lactam allergy before administration. Among the surgeries audited, 83.7% compliance was noted for the timing of administration of antibiotics, however, in only 42 (26.7%) cases SAP was stopped within 24 h of surgery and in only 38 (24.2%) cases cefazolin/cefuroxime was given as prophylaxis. Conclusion: This study highlighted the importance of knowledge and awareness of SAP guidelines among surgeons. There is a need to train surgeons regarding this important issue.