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Current Surgical Antibiotic Prophylaxis Practices: A Survey of Orthopaedic Surgeons in India

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Abstract

Background

Surgical antibiotic prophylaxis (SAP) has become the standard of care in orthopaedic surgery. Inappropriate usage of antibiotics (dosage, strength, and/or administration time and duration) can inadvertently result in superadded infections and antimicrobial resistance. The purpose of this study was to document and analyse the prescription patterns for SAP, and to investigate the factors associated with divergence from standard guidelines.

Methods

We conducted an online cross-sectional questionnaire-based study to collect information about the SAP practices of the members of the Indian Orthopaedic Association (IOA) using Google forms. A link to the questionnaire was sent by e-mails.

Results

The overall response rate was 5.73%. While 97.3% respondents practised SAP routinely, the practice was not aligned with standard guidelines’ recommendations. There was heterogeneity in the use of SAP in terms of choice of antibiotic(s), number of co-prescribed drugs, single- versus multiple-dose regimens, and the duration of therapy. The prescription practice patterns showed that orthopaedic surgeons almost always used broad-spectrum antibiotics for long durations, regardless of the type of surgery.

Conclusion

While Orthopaedic surgeons in India are practicing SAP, the pattern of antibiotic usage is heterogeneous. Variations were noted in the choice of antibiotics for different types of surgeries, time of administration, duration of usage in the postoperative period as well as co-prescriptions. This study highlights the urgent need for a comprehensive, rational, and robust national SAP policy for orthopaedic surgeries.

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Author information

Authors and Affiliations

  1. Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, 462020, India

    John Ashutosh Santoshi & Prateek Behera

  2. Department of Trauma and Emergency Medicine (Orthopaedics), All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, 462020, India

    Manoj Nagar

  3. Senior Director, Institute of Orthopaedics, Max Hospital, Mohali, Punjab, India

    Ramesh Sen

  4. Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, 462020, India

    Anirban Chatterjee

Authors
  1. John Ashutosh Santoshi
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  2. Prateek Behera
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  3. Manoj Nagar
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  4. Ramesh Sen
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  5. Anirban Chatterjee
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Contributions

Conceptualisation: JAS, PB. Methodology: JAS, MN, RS. Formal analysis and investigation: PB, AC. Writing—original draft preparation: JAS, PB, MN. Writing—review and editing: RS. Funding acquisition: not applicable. Resources: AC (software for statistical analysis). Supervision: RS.

Corresponding author

Correspondence to Prateek Behera.

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The authors declare that they have no conflict of interest.

Ethical standard statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Human Ethics Committee, All India Institute of Medical Sciences, Bhopal, MP, India, IHEC-LOP/2020/IM0243, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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43465_2020_306_MOESM1_ESM.pdf

Supplementary file1 Shows the relation of the age of the respondent and the years of experience in relation to their major field of orthopaedic practice (PDF 153 KB)

Supplementary file2 (PDF 77 KB)

Supplementary file3 (PDF 126 KB)

Supplementary file4 (PDF 76 KB)

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Santoshi, J.A., Behera, P., Nagar, M. et al. Current Surgical Antibiotic Prophylaxis Practices: A Survey of Orthopaedic Surgeons in India. JOIO 55, 749–757 (2021). https://doi.org/10.1007/s43465-020-00306-0

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  • DOI: https://doi.org/10.1007/s43465-020-00306-0

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