Abstract of Dissertation

Keyword : SSI- Surgical Site Infection, ABS –Antibiotics; Antibiotic Policy

Objective : To assess the rational use of antibiotics in the hospital. To create an awareness among the hospital consultant and to save uses of powerful antibiotics for later treatment

Background : In a hospital SSI infections are the commonest hospital acquired infections for a surgical patient. Approximately 30-40% of antibiotics used in hospital are for surgical prophylaxis. An appropriate prescription of antibiotic is needed for an efficient treatment. A failure can lead to treatment inefficiency or increase the emergence of antimicrobial resistance. Judicial use of antibiotic through an efficient antibiotic policy (Abs) is thus essential. In a multispecialty tertiary care hospital particularly using the previously dated antibiotic policy which is focusing on a single speciality has own its inefficiency for the other speciality, and upgraded antibiotic policy requirement thus is necessary, to ensure the appropriate use of antibiotics. More options are thus available for patient in future for fighting against infection. It also provides information to the doctor regarding latest trends of infection which influence their decision while prescribing antibiotic.

Methodology : A retrospective study was conducted at Multispecialty tertiary care Hospital, Hyderabad; the data is captured form year 2014-2015. A total of 1206 blood culture specimens was received in the microbiology department during the study period of which there were 131 blood culture positives. The demographic details and microbiology susceptibility data of the patients with positive blood cultures were recorded and this data was subsequently analysed.

Findings : Antibiograms were prepared for species with minimum 30 isolates and expressed as percentage susceptible. Only routinely used drugs having a percentage susceptibility of ≥ 40% were included in the hospital antibiogram.

Recommendations : For judicial use of antibiotic as per the policy, the antibiotics were classified as Empirical Drug and Therapeutic Drug. The cumulative antibiograms were presented on 27th April in a hospital infection control meeting attended by clinicians, hospital administrators, microbiologist, infection control nurse and nursing superintendent and an antibiotic policy for initial empiric therapy of bloodstream infections was formulated.