Evaluation of Knowledge Practice on Antimicrobial Prophylaxis in Surgery Among Surgeons and Clinical Pharmacists at Kenyatta National Hospital

Abstract

Background Surgical site infections are major contributors to increased mortality and healthcare costs globally which can be reduced by appropriate prophylactic antibiotic use which is guided by selection of antimicrobial agent (s), route of administration, timing of first dose and duration of prophylactic therapy. There is limited published literature on clinicians knowledge and practice on antimicrobial prophylaxis in surgery and hence the impetus for the present study. Objectives To evaluate the knowledge and practice of surgeons and clinical pharmacists on antimicrobial prophylaxis in surgery at KNH. Methodology A cross sectional design was used where sixty one respondents were selected using stratified random sampling at KNH. The target population comprised of consultants surgeons, registrars and clinical pharmacists. Data on knowledge and practice of antimicrobial prophylaxis in surgery were collected with a structured questionnaire and analysed using STATA version 13 software. Approval to carry out the study was granted by KNH/UoN Ethical Review Committee (ERC). Results The ratio of males to females was 1.0 to 0.7 and the mean age of the participants was 37.7(±8.5) years. Registrar surgeons comprised the majority of the participants at 60.7% followed by consultant surgeons at 27.9%. Ceftriaxone was the most preferred antimicrobial agent in surgical prophylaxis (79.8%). Participants were aware of the timing of prophylaxis and duration of drug use. However, there were some varied reports on antimicrobial agents used in different surgery departments. On the practice, intra – venous route was preferred (98.4%) for the administration of prophylactic antimicrobial agent and timing of first dose was mostly reported to be pre – surgery (95.1%) and duration for prophylactic therapy was reported to be within 24 hours. Conclusion Ceftriaxone was the antimicrobial agent of choice for surgical antimicrobial prophylaxis, mostly administered via the intra – venous route. It was mostly administered pre – surgery with prophylaxis mostly lasting up to 24 hours post – surgery.