OBJECTIVES:

To evaluate the incidence, types and Days of Redundant Antibiotic Prophylaxis in obstetric and gynaecologic surgeries in Northern Nigeria

METHODS:

This analysis is part of a study that evaluated the appropriateness of surgical antibiotic prophylaxis in three tertiary hospitals in Northern Nigeria. The study was conducted over a 10-week period. Antibiotic prophylaxis prescriptions for all clean, clean-contaminated, and contaminated Obstetric and Gynaecology surgeries during the study were evaluated. Patient medication chart, medical and anaesthesia records were reviewed for data collection. Redundant antibiotic prophylaxis was defined as use of antibiotic with same spectra of activity for surgical prophylaxis. Only one redundant combination per patient was reported.

RESULTS:

Two hundred and forty-eight patients were involved in the study. The mean age and length of hospitalization are 31.7 (± 7.9) and 6.4 (± 2.7) respectively. Duration of surgical antibiotic was prolonged in all the patients (mean = 8.7 ± 1.0). Out of 248 patients, 179 (72.2%) had a prescription with redundant antibiotic combination. Combinations of antianaerobics, and cephalosporin with aminoglycoside were the type of redundant antibiotic prescriptions encountered in this group. The most common redundant combination was amoxicillin clavulanic acid plus metronidazole 174 (95.1%) times, followed by ceftriaxone plus aminoglycoside 6 (3.3%) times. Redundant antibiotic combination was significantly higher in clean-contaminated surgeries (46.4%) and obstetric procedures (83.8%). The Days of Redundant Antibiotic Prophylaxis was 1286 per 100 procedures.

CONCLUSIONS:

About three quarter of women who undergo obstetric and gynaecologic surgeries receive antibiotics with redundant spectra of activity. This study underlies the importance of antibiotic stewardship interventions.