Evaluation of the practice of surgical antibiotic prophylaxis in a Zonal Referral Hospital in Mbujimayi, Democratic Republic of the Congo (DRC).

BACKGROUND: Surgical Antibiotic Prophylaxis (SAP) is helpful in preventing patients from developing Surgical Site Infections (SSI). In Mbujimayi, the documentation on the practice of SAP is outdated and inadequate. The last study was conducted more than 5 years ago. This study aims at assessing the compliance of the practice of antibiotic prophylaxis in the surgical and obstetrics-gynecology departments of the Bonzola Zonal Referral Hospital (BZRH) compared to the international standards. METHODS: A prospective observational study was conducted from March 2020 to March 2021 involving 324 surgical patients who received antibiotic prophylaxis. Interventions were assessed as "compliant" if all the variables individually complied with the criteria for antibiotic prophylaxis use. RESULTS: Three hundred and twenty-four patients were enrolled in this study. Compliance was found to be 87.35% for the indication for administration; 0.31% for the choice of the molecule; 3.65% for the time of the first administration; none for the duration of antibiotic prophylaxis. Therefore, the overall compliance was nil. This study shows a significant gap when the current practice in Mbujimayi town is compared to the recommendations of international societies. CONCLUSION: SAP is often indicated in accordance with international recommendations in Mbujimayi. However, the choice of the molecule, the dosage, the time of first administration and the duration of SAP deviate from them. Thus, the compliance of SAP is nil.

Compliance of antibiotics used for surgical site infection prophylaxis among patients undergoing surgery in a Congolese teaching hospital.

BACKGROUND: Surgical antibiotic prophylaxis (SAP) is one of the measures used for preventing surgical site infections. SAP has high impact but there is low compliance with antimicrobial guidelines in many developing countries like the Democratic Republic of the Congo. This study aimed to assess the compliance of antibiotics used for surgical site infection prophylaxis with international guidelines among patients undergoing surgery at the "Cliniques Universitaires du Graben" (CUG). METHODS: This was a retrospective study including all patients who underwent surgery and received SAP between January 2017 and December 2018 at CUG. Surgical and Gynaecology-Obstetric patients were included. A total of 265 patients were included in the analysis. A standardized questionnaire was used for collecting pre-, per-, and post-operative data. The compliance of SAP was assessed for all patients. Data were analysed using SPSS version 22. RESULTS: The compliance rate ofSAP among patients undergoing surgery at CUG was 18.1%. Emergency surgery increased the risk of SAP non-compliance by three fold (OR=3.5, 95% CI: 1.0-11.8, p = 0.033). The most frequent antibiotics used in SAP were ampicillin, cloxacillin, gentamicin and ceftriaxone, alone or in combination. Categories of non-compliance included; inappropriate initial dose of antibiotic (compliance rate of 23.8%) and incorrect duration of antibiotic use (compliance rate of 30.9%). Among the included patients, 22 (8.3%) presented with a surgical site infection, of those 20 (90.9%) had received non-compliant SAP. CONCLUSION: The correct use of SAP among patients undergoing surgery at CUG is low. Implementing measures to optimize adherence to SAP guidelines should be encouraged. A high rate of surgical site infections is observed in cases where the SAP is prescribed or administered in a non-compliant manner.