Appropriateness of Antibiotic Prophylaxis in Gynecologic Surgery at Srinagarind Hospital
Lingling Sae-Tia MD*, Chompilas Chongsomchai MD, MHS*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen
Objective : To evaluate the rate of appropriate prophylactic antibiotic use in gynecologic surgery at Srinagarind
Hospital.
Design study: Prospective descriptive study.
Setting : Srinagarind Hospital, Khon Kaen University, Thailand
Materials and Methods : Medical records of 250 women who had undergone gynecologic surgery at Srinagarind
Hospital during August 2004 and February 2005 were evaluated. The criteria of appropriate prophylactic
antibiotics were based on ACOG recommendation 2001. Data on demographic information, surgery proce-
dure and antibiotic use during surgery were extracted from these medical records and analyzed.
Main outcomes: Rate of appropriate prophylactic antibiotic use and type of inappropriate use.
Results : Two hundred and fifty women had undergone gynecologic surgery during the study period. There
were 168 total abdominal hysterectomy (TAH), 12 vaginal hysterectomy (VH), 30 salpingooophorectomy
(SO), 3 myomectomy, 30 diagnostic laparoscopy and 7 laparoscopic ovarian cystectomy (LOC). Twenty
private staff and twenty residents conducted these operations. The overall rate of appropriate prophylactic
antibiotic use was 75.2% (95%CI 69.28-80.33). Main type of inappropriate use were multiple doses and
indication not fulfilled. The overall rate of appropriate antibiotic prophylaxis among surgeries conducted by
private staff was 53.19% (95%CI 42.66-63.46) and the overall rate of appropriate antibiotic prophylaxis
among surgeries conducted by residents was 88.46% (95%CI 82.13-93.83). The rate of early post operative
infection between both groups was not different (p = 0.529). There was no drug complication in all subjects.
Conclusion : The overall rate of appropriate antibiotic prophylaxis in gynecologic surgery at Srinagarind
Hospital was 75.2% (95%CI 69.28-80.33). Residents used prophylactic antibiotics more appropriately than
private staff.
Keywords : Prophylactic antibiotics, Gynecologic surgery, Total abdominal hysterectomy, Vaginal hysterec- tomy, Salpingooophorectomy, Diagnostic laparoscopy, Llaparoscopic ovarian cystectomy
