Evaluation and optimization of antibiotic selection for surgical prophylaxis in Ahmedabad region

Objectives: To assess the antibiotic prescribing trends for surgical prophylaxis across selected healthcare centers in Ahmedabad and to evaluate their alignment with standard guidelines.
Methods: This retrospective, multi-centric observational study was conducted over 6 months across tertiary care hospitals in Ahmedabad. Patient records from surgical departments were screened to analyses the prophylactic antibiotic choice, dosage forms, frequency, post-operative prescribing patterns, and associated parameters. Surgeries were classified based on wound type (clean, clean-contaminated, contaminated, dirty), and data was compiled on demographics, culture sensitivity tests, and antibiotic cost.
Results: Of the included cases, the majority underwent procedures categorized as clean or clean-contaminated. Ceftriaxone and Amikacin were the most frequently prescribed prophylactic antibiotics, often in combination. In certain cases, non-recommended agents such as third-generation cephalosporins were used indiscriminately. Culture sensitivity testing revealed predominant organisms including E. coli and Staphylococcus aureus. Despite available guidance (ICMR, CDC), notable deviations were observed in dosage frequency, timing, and antibiotic coverage, leading to increased costs and suboptimal outcomes.
Conclusion: The findings underscore a disconnect between prescribed surgical prophylactic antibiotics and recommended evidence-based guidelines. There is a need for greater awareness, periodic audits, and stricter adherence to antimicrobial prophylaxis protocols to mitigate resistance and improve patient safety. Implementation of stewardship programs and education across surgical departments could significantly enhance rational antibiotic use.