Surgical site infection and antibiotics use pattern in a tertiary care hospital in Nepal.

OBJECTIVE To obtain information on surgical site infection (SSI) and the regimens used for surgical prophylaxis. METHODS The study was carried out at Manipal Teaching Hospital, Pokhara, Nepal from 1st January to 30th June 2004. Inpatients and outpatients undergoing surgical procedures in General Surgery department were included. Data was collected on a specially designed proforma. Demographic details, details of SSI, results of culture/sensitivity testing and antibiotics used for prophylaxis were noted. Associations of SSI with different variables were studied. RESULTS A total of 507 patients were included. SSI was noted in 37 patients (7.3%), of which 21 (56.8%) were superficial SSI. Total duration of antibiotic use, type of anaesthesia and post-operative fever showed significant statistical association with SSI. Organisms were isolated in 12 out of 37 SSI cases (32.4%). E. coli was the most organism isolated. Combination of ampicillin and cloxacillin was the most commonly used antibiotic regimen (138 patients) followed by combination of ampicillin, cloxacillin and metronidazole (26 patients). CONCLUSIONS The incidence of SSI was higher compared to developed countries. Surveillance systems for SSI and hospital guidelines for antibiotic prophylaxis are required.