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  1. Utilization of surgical antibiotic prophylaxis for obstetrics and gynaecology surgeries in Northern Nigeria
    Abubakar U, Syed Sulaiman SA, Adesiyun AG
    Int J Clin Pharm, 2018 Oct;40(5):1037-1043.
    PMID: 30054786 DOI: 10.1007/s11096-018-0702-0
    Background Audit of antibiotic prophylaxis is an important strategy used to identify areas where stewardship interventions are required. Objectives To evaluate compliance with surgical antibiotic prophylaxis in obstetrics and gynaecology surgeries and determine the Defined Daily Dose (DDD) of antibiotic. Settings Three public tertiary hospitals located in Northern Nigeria. Methods This prospective study included women who had obstetrics and gynaecology surgeries with no infection at the time of incision. Appropriateness of antibiotic prophylaxis was determined by a clinical pharmacist. DDD of antibiotics was determined using ATC/DDD index 2017 from the World Health Organization Collaborating Centre for Drugs Statistics Methodology. Main outcome measure Compliance with antibiotic prophylaxis and DDD of antibiotic per procedure. Results A total of 248 procedures were included (mean age: 31.7 ± 7.9 years). Nitroimidazole in combination with either beta-lactam/beta-lactamase inhibitor or third generation cephalosporin were the most prescribed antibiotics. Redundant anaerobic antibiotic combination was detected in 71.4% of the procedures. Timing of antibiotic prophylaxis was optimal in 16.5% while duration of prophylaxis was prolonged in all the procedures (mean duration was 8.7 ± 1.0 days). The DDD of antibiotics prophylaxis was 16.75 DDD/procedure. Antibiotic utilisation was higher in caesarean section and myomectomy (17.9 DDD/procedure) than hysterectomy (14.5 DDD/procedure); P 
    Matched MeSH terms: Antibiotic Prophylaxis/methods*; Antibiotic Prophylaxis/trends
  2. Fulltext Urinary tract infections in pregnancy
    Loh KY, Sivalingam N
    Malays Fam Physician, 2007;2(2):54-57.
    MyJurnal
    Urinary tract infections frequently affect pregnant mothers. This problem causes significant morbidity and healthcare expenditure. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remains the most frequent organism isolated in UTIs. All pregnant mothers should be screened for UTIs in pregnancy and antibiotics should be commenced without delay. Urine culture and sensitivity is the gold standard in diagnosing UTIs. Without treatment, asymptomatic bacteriuria in pregnancy is associated with preterm delivery, intrauterine growth retardation, low birth weight, maternal hypertension, pre-eclampsia and anaemia. Acute pyelonephritis can lead to maternal sepsis. Recurrent UTIs in pregnancy require prophylactic antibiotic treatment.
    Matched MeSH terms: Antibiotic Prophylaxis
  3. The prophylaxis of typhus fever and vaccination against that disease
    Biraud Y
    Malayan Medical Journal, 1937;12:155-6.
    Matched MeSH terms: Antibiotic Prophylaxis
  4. Fulltext The World-wide Randomized Antibiotic Envelope Infection Prevention (WRAP-IT) trial: Long-term follow-up
    Mittal S, Wilkoff BL, Kennergren C, Poole JE, Corey R, Bracke FA, et al.
    Heart Rhythm, 2020 07;17(7):1115-1122.
    PMID: 32087357 DOI: 10.1016/j.hrthm.2020.02.011
    BACKGROUND: The World-wide Randomized Antibiotic Envelope Infection Prevention trial reported a 40% reduction in major cardiac implantable electronic device (CIED) infections within 12 months of the procedure with the use of an antibacterial-eluting envelope (TYRX Absorbable Antibacterial Envelope, Medtronic, Mounds View, MN).

    OBJECTIVE: The purpose of this report was to describe the longer-term (>12 months) envelope effects on infection reduction and complications.

    METHODS: All trial patients who underwent CIED replacement, upgrade, revision, or initial cardiac resynchronization therapy - defibrillator implantation received standard-of-care infection prophylaxis and were randomized in a 1:1 ratio to receive the envelope or not. CIED infection incidence and procedure and system-related complications were characterized through all follow-up (36 months) by using Cox proportional hazards regression modeling.

    RESULTS: In total, 6800 patients received their intended randomized treatment (3371 envelope; 3429 control; mean follow-up period 21.0 ± 8.3 months). Major CIED-related infections occurred in 32 envelope patients and 51 control patients (Kaplan-Meier [KM] estimate 1.3% vs 1.9%; hazard ratio [HR] 0.64; 95% confidence interval [CI] 0.41-0.99; P = .046). Any CIED-related infection occurred in 57 envelope patients and 84 control patients (KM estimate 2.1% vs 2.8%; HR 0.69; 95% CI 0.49-0.97; P = .030). System- or procedure-related complications occurred in 235 envelope patients and 252 control patients (KM estimate 8.0% vs 8.2%; HR 0.95; 95% CI 0.79-1.13; P < .001 for noninferiority); the most common were lead dislodgment (1.1%), device lead damage (0.5%), and implant site hematoma (0.4%). Implant site pain occurred less frequently in the envelope group (0.1% vs 0.4%; P = .067). There were no (0.0%) reports of allergic reactions to the components of the envelope (mesh, polymer, or antibiotics).

    CONCLUSION: The effects of the TYRX envelope on the reduction of the risk of CIED infection are sustained beyond the first year postprocedure, without an increased risk of complications.

    Matched MeSH terms: Antibiotic Prophylaxis/methods*
  5. The Impact of Antimicrobial Stewardship Program on Injudicious Use of Cefuroxime
    Arulappen AL, Danial M, Haron N, Hau LC, Khan AH
    Front Pharmacol, 2020;11:565818.
    PMID: 33664664 DOI: 10.3389/fphar.2020.565818
    Antimicrobial stewardship (AMS) program promotes the judicious use of antimicrobials. Hence, this study was conducted to analyze the impact of stewardship on the prescribing pattern of cefuroxime injection among the surgeons as perioperative antimicrobial prophylaxis (PAP). This study was conducted retrospectively in Malaysia. Various outcomes were measured including cefuroxime usage, compliance with the guidelines, surgical site infections, and cost savings. A total of 1,601 patients were recruited in the study. In terms of usage, the total defined daily dose (DDD) prior to the intervention was 202 DDD/100 procedures compared to that after intervention which was 144 DDD/100 procedures (p < 0.05). On the other hand, the excessively long administration of PAP dropped from 94.4 to 30.3% (p < 0.001). Focusing on the compliance with the newly developed local guidelines, it has increased from 53 to 94.3% after the interventions were made (p < 0.001), whereas the rate of surgical site infections was reduced from 17.0 to 9.0%. The cost of antibiotic being used has significantly reduced after the study intervention (p = 0.007). The quality of PAP directly impacts the antimicrobial usage, the surgical site infections, and the total cost involved. Thus, it is crucial to maintain the standard of PAP at all times in healthcare settings.
    Matched MeSH terms: Antibiotic Prophylaxis
  6. Fulltext Surgical antibiotic prophylaxis: incidence and risk of surgical site infection
    Fadzwani B, Raha A.R, Nadia M.N, Wan Rahiza WM, Razman J, Nordiah A.J
    IIUM Medical Journal Malaysia, 2020;19(1):45-53.
    MyJurnal
    Introduction: This prospective cross sectional study assessed surgical antibiotic prophylaxis (SAP) practice,
    the incidence of surgical site infection (SSI) and its associated risks in Universiti Kebangsaan Malaysia Medical
    Centre. Methods: Patients for elective colorectal, hepatobiliary, upper gastrointestinal, breast and
    endocrine surgery, who received SAP were included and followed up until day-30 postoperatively. Types of
    antibiotic, preoperative–dose timing, intraoperative re-dosing and its duration were recorded. The incidence
    of SSI was calculated and its associated risks expressed in odds ratio. Results: Out of 166 patients recruited,
    121 (72.89%) patients received SAP preoperatively, and 91 (75.21%) of them were prescribed the appropriate
    antibiotic as per our institutional guideline. Three patients who continued to receive therapeutic antibiotic
    postoperatively were excluded from statistical analysis. Eleven (9.10%) patients received SAP beyond the
    preoperative–dose timing of 60 minutes (p=0.001), which was an independent risk factor for SSI (adjusted OR
    4.527, 95% CI; 1.058-19.367, p=0.042). The risk of SSI also remained in patients who continued to receive
    SAP beyond 24 hours (OR 4.667, 95% CI; 1.527-14.259, p=0.007). The overall rate of SSI was 17.18%.
    Conclusion: We found that the choice of antibiotic prescribed for SAP was in accordance to institutional
    guideline and the relatively high SSI incidence was similar to a recent local report. Although the number of
    patients receiving preoperative dose-timing of > 60 minutes was low, it was nonetheless an independent risk
    factor for SSI. The postoperative continuation of SAP for more than 24 hours showed no benefit in reducing
    SSI.
    Matched MeSH terms: Antibiotic Prophylaxis
  7. Fulltext Surgical Prophylaxis Guide 2018
    ISBN: 978-967-16406-0-9
    Citation: Surgical Prophylaxis Guide 2018. Kuala Lumpur: Antimicrobial stewardship committee, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia; 2018
    Matched MeSH terms: Antibiotic Prophylaxis
  8. Fulltext Surgeons' adherence to guidelines for surgical antimicrobial prophylaxis - a review
    Ng RS, Chong CP
    Australas Med J, 2012;5(10):534-40.
    PMID: 23173017 DOI: 10.4066/AMJ.2012.1312
    Surgical site infections are the most common nosocomial infection among surgical patients. Patients who experience surgical site infections are associated with prolonged hospital stay, rehospitalisation, increased morbidity and mortality, and costs. Consequently, surgical antimicrobial prophylaxis (SAP), which is a very brief course of antibiotic given just before the surgery, has been introduced to prevent the occurrence of surgical site infections. The efficacy of SAP depends on several factors, including selection of appropriate antibiotic, timing of administration, dosage, duration of prophylaxis and route of administration. In many institutions around the globe, evidence-based guidelines have been developed to advance the proper use of SAP. This paper aims to review the studies on surgeons' adherence to SAP guidelines and factors influencing their adherence. A wide variation of overall compliance towards SAP guidelines was noted, ranging from 0% to 71.9%. The misuses of prophylactic antibiotics are commonly seen, particularly inappropriate choice and prolonged duration of administration. Lack of awareness of the available SAP guidelines, influence of initial training, personal preference and influence from colleagues were among the factors which hindered the surgeons' adherence to SAP guidelines. Immediate actions are needed to improve the adherence rate as inappropriate use of SAP can lead to the emergence of a strain of resistant bacteria resulting in a number of costs to the healthcare system. Corrective measures to improve SAP adherence include development of guidelines, education and effective dissemination of guidelines to targeted surgeons and routine audit of antibiotic utilisation by a dedicated infection control team.
    Matched MeSH terms: Antibiotic Prophylaxis
  9. Spontaneous bacterial peritonitis [SBP]
    Chutaputti A
    Med J Malaysia, 2005 Jul;60 Suppl B:12-4.
    PMID: 16108166
    Matched MeSH terms: Antibiotic Prophylaxis/methods*
  10. Fulltext Single-dose antibiotic prophylaxis in women undergoing elective caesarean section
    Huam SH, Lim JM, Raman S
    Med J Malaysia, 1997 Mar;52(1):3-7.
    PMID: 10968046
    This prospective, randomised, controlled trial was performed to evaluate the effectiveness of single-dose antibiotic prophylaxis in decreasing the infectious morbidity following elective caesarean section. Two hundred women undergoing elective caesarean section were randomly assigned to receive either 1.2 g of Augmentin intravenously, or no treatment, just before the start of their caesarean section. The two groups of women were comparable in terms of patient characteristics and operation variables. The overall postoperative morbidity rate was 19% in the Augmentin treated group versus 38% in the group that received no prophylaxis (p < 0.01). The incidence of wound sepsis was 3% in the Augmentin group versus 13% in the control group (p < 0.01). The incidence of febrile morbidity with no identifiable cause was 8% in the Augmentin group versus 18% in the control group (p < 0.05). The duration of hospital stay was significantly shorter in the Augmentin group (p < 0.05). A single-dose of prophylactic Augmentin significantly reduced the postoperative morbidity and duration of hospital stay in women who underwent elective caesarean sections.
    Matched MeSH terms: Antibiotic Prophylaxis*
  11. Fulltext Screening of antenatal mothers and prevention of perinatal group B streptococcal infection
    Raj, M., Razali N,, Sulaiman, S.
    JUMMEC, 2009;12(1):27-30.
    MyJurnal
    The objectives of this study were: (1) to detect group B streptococcus (GBS) carriers among antenatal patients during pregnancy ( 35 to 37 weeks) in the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia, and (2) to give antibiotic prophylaxis during the intrapartum period for the GBS carrier patients. The aim is to prevent early onset of GBS infection in newborn. This pilot study was carried out from 1st July 2005 to 31st August 2005. It is a prospective study involving 56 pregnant women who were seen at the antenatal clinic in the UMMC between 35 to 37 weeks gestation. High vaginal swab and low vaginal together with endoanal swab were taken for culture and sensitivity. The antibiotic prophylaxis was started early in the intrapartum period for patients with positive culture for GBS. GBS was detected in 18 patients which contributes to about 32% of the study population. The proper choice of antibiotic is important in successful disease prevention.

    Study site: Obstretic and gynaecological clinic, University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Antibiotic Prophylaxis
  12. Fulltext Role of prophylactic antibiotics in cirrhotic patients with variceal bleeding
    Lee YY, Tee HP, Mahadeva S
    World J Gastroenterol, 2014 Feb 21;20(7):1790-6.
    PMID: 24587656 DOI: 10.3748/wjg.v20.i7.1790
    Bacterial infections are common in cirrhotic patients with acute variceal bleeding, occurring in 20% within 48 h. Outcomes including early rebleeding and failure to control bleeding are strongly associated with bacterial infection. However, mortality from variceal bleeding is largely determined by the severity of liver disease. Besides a higher Child-Pugh score, patients with hepatocellular carcinoma are particularly susceptible to infections. Despite several hypotheses that include increased use of instruments, greater risk of aspiration pneumonia and higher bacterial translocation, it remains debatable whether variceal bleeding results in infection or vice versa but studies suggest that antibiotic prophylaxis prior to endoscopy and up to 8 h is useful in reducing bacteremia and spontaneous bacterial peritonitis. Aerobic gram negative bacilli of enteric origin are most commonly isolated from cultures, but more recently, gram positives and quinolone-resistant organisms are increasingly seen, even though their clinical significance is unclear. Fluoroquinolones (including ciprofloxacin and norfloxacin) used for short term (7 d) have the most robust evidence and are recommended in most expert guidelines. Short term intravenous cephalosporin (especially ceftriaxone), given in a hospital setting with prevalent quinolone-resistant organisms, has been shown in studies to be beneficial, particularly in high risk patients with advanced cirrhosis.
    Matched MeSH terms: Antibiotic Prophylaxis*
  13. Fulltext Role of intravitreal/intracameral antibiotics to prevent traumatic endophthalmitis - Meta-analysis
    Thevi T, Abas AL
    Indian J Ophthalmol, 2017 Oct;65(10):920-925.
    PMID: 29044054 DOI: 10.4103/ijo.IJO_512_17
    Traumatic endophthalmitis is a devastating condition that can occur following an open globe injury and result in loss of vision. The use of prophylactic antibiotics is empirical as most surgeons fear complications associated with the same. No systematic review has been performed in English on the role of intravitreal/intracameral antibiotics in preventing traumatic endophthalmitis. We searched for randomized controlled trials and controlled clinical trials comparing intracameral/intravitreal antibiotics with placebos on PubMed, Google Scholar, Science Direct, and Cochrane Library using keywords open globe/trauma/penetrating/perforating injuries endophthalmitis. The last search was on 5 May 2017. We included patients of all ages with open globe injuries who received intracameral/intravitreal antibiotics, regardless of the dose. Quality of the trials was assessed using Cochrane collaboration tools to assess the risk of bias. The main outcome measures were endophthalmitis and visual acuity. We included three trials. Overall, intravitreal/intracameral antibiotics were noted to significantly reduce the occurrence of endophthalmitis in open globe injuries (relative risk [RR] 0.19, 95% confidence interval [CI] 0.06-0.57). The use of intravitreal/intracameral antibiotics did not have an effect in improving visual acuity (RR 1.17, 95% CI 0.61-2.23). Two trials (Narang 2003; Soheilan 2001) were observed to have no significant effect on visual acuity while another trial (Soheilan 2007) did not list visual acuity as part of its objectives. Intracameral/intravitreal antibiotics reduce the risk of endophthalmitis in open globe injuries; although, there was no improvement in the visual acuity. We, therefore, recommend the use of intravitreal/intracameral injections in open globe injuries to prevent this devastating complication.
    Matched MeSH terms: Antibiotic Prophylaxis/methods*
  14. Fulltext Review on prophylactic antibiotics for dental patients with prosthetic joints
    Chai WL, Yong CK, Ngeow WC
    Ann Dent, 2003;10(1):22-26.
    MyJurnal
    Most prosthetic joint infections originate from wound contamination or haematogenous seeding from distant sites of infection. Bacteraemia may follow dental treatment but there is little evidence of it related to prosthetic joint infection. Nevertheless, controversy continues with regards to the effect of dental treatment in patients with prosthetic joints. This article reviews current English literature regarding the use of antibiotic prophylaxis in the dental management of patients with prosthetic joints. Routine antibiotic prophylaxis is not recommended for every patient with prosthetic joints when receiving dental treatments. However, antibiotic prophylaxis may be prescribed for high-risk groups with predisposing factors to infection when undergoing dental treatment with high risk of bacteraemia.
    Matched MeSH terms: Antibiotic Prophylaxis
  15. Red man syndrome during administration of prophylactic antibiotic against infective endocarditis
    Ngeow WC, Chai WL, Moody AB
    J Ir Dent Assoc, 2000;46(3):92-4.
    PMID: 11323942
    Red man syndrome (RMS) is the occurrence flushing, pruritus, chest pain, muscle spasm or hypotension during vancomycin infusion. It usually happens as a result of rapid infusion of the drug but may also occur after slow administration. The frequency and severity of this phenomenon diminish with repeated administration of vancomycin. A case is presented whereby RMS occurred while prophylactic antibiotic against infective endocarditis was administered.
    Matched MeSH terms: Antibiotic Prophylaxis/adverse effects*
  16. Providing guidelines and education is not enough: an audit of gentamicin use at The Royal Melbourne Hospital
    Leong CL, Buising K, Richards M, Robertson M, Street A
    Intern Med J, 2006 Jan;36(1):37-42.
    PMID: 16409311
    BACKGROUND: Aminoglycoside antibiotics are commonly prescribed for the treatment of Gram-negative infections. Appropriate dosing and therapeutic monitoring of aminoglycosides are important because these agents have a narrow therapeutic index.
    AIM: To audit gentamicin use at our hospital, focusing on selection of the initial dose and therapeutic monitoring practices, and to compare the results against recommendations in the existing hospital aminoglycoside guidelines, which had recently been promoted to doctors.
    METHODS: This audit included all inpatients receiving gentamicin at The Royal Melbourne Hospital from 1 February to 12 March 2004. The principal researcher checked the drug charts of all inpatients to identify those receiving gentamicin and collected data from the medical records and the pathology database. Doses were considered 'concordant' if the dose given was within the recommended dosing range +/-20 mg.
    RESULTS: A total of 132 courses of gentamicin was included in the study. Gentamicin was prescribed for prophylaxis in 31.1% of courses. Thirty-six per cent of patients prescribed gentamicin were more than 65 years of age. Eighty-two per cent of the gentamicin used therapeutically was given as a single daily dose. Sixty-six per cent of gentamicin initial dosing was not in accordance with existing hospital guidelines. Seventy-seven per cent of gentamicin courses requiring therapeutic drug monitoring received such monitoring; however, in only 8.8% of these was the monitoring conducted according to guidelines.
    CONCLUSION: Aminoglycoside prescribing practices at our hospital are suboptimal, despite ready access to prescribing guidelines. Provision of a guideline and education sessions with doctors do not necessarily lead to widespread adoption of recommended practices. We suggest that changes to hospital systems related to prescribing and monitoring of aminoglycosides are required.
    Matched MeSH terms: Antibiotic Prophylaxis
  17. Fulltext Prophylactic antibiotics in orthopaedic surgery: guidelines and practice
    Yeap JS, Lim JW, Vergis M, Au Yeung PS, Chiu CK, Singh H
    Med J Malaysia, 2006 Jun;61(2):181-8.
    PMID: 16898309
    The national clinical practice guideline has recommended that prophylactic antibiotic be given in orthopaedic surgery involving joint replacements and internal fixation of fractures. The aim of this study is to assess the current antibiotics prophylaxis practice in a state level hospital. One hundred and three patients (68 males, 35 females; mean age 41.6 +/- 22.2 years) undergoing internal fixation for closed fractures and joint replacement surgery were included in this prospective study. The choice of pre and post-operative antibiotics, their dosages and duration of administration were recorded. The pre-operative antibiotics were only deemed to have been given if it was documented in the case notes and in the case of post-operative antibiotics if it was signed on the drug chart. Eighty eight percent were given pre-operative prophylactic antibiotics and 92% were given post-operative antibiotics. For patients undergoing internal fixation of fractures, the most commonly used antibiotic for both pre and post-op is intravenous cefuroxime. For joint replacement surgery, the most commonly used antibiotic is intravenous cefoperazone. The duration or number of doses of post-operative antibiotics was highly variable. It was not stated in 56% of the post-operative instructions. Post-operative antibiotic was ordered for 48 hours or longer in 10%. In conclusion, prophylactic antibiotics appear to be widely practised. The first line antibiotics as recommended by the present guideline were not given in any of the patients. Second generation followed by third generation cephalosporins are the most popular antibiotics, with a trend towards using third generation cephalosporins in arthroplasty patients. Single dose prophylaxis was rarely practised.
    Matched MeSH terms: Antibiotic Prophylaxis/standards*
  18. Prevention of infection in the immunocompromised
    Lim VK
    Ann Acad Med Singap, 1997 May;26(3):331-5.
    PMID: 9285028
    Infection is an important cause of morbidity and mortality in immunocompromised patients. The high risk of infection is not only the consequence of the underlying disease but also the result of the diagnostic, monitoring and therapeutic procedures performed on these patients. Infections may be exogenous or endogenous in origin. The prevention of exogenous infections requires a high standard of hygiene. As many infections are acquired in hospitals, an effective control of nosocomial infection programme is crucial in preventing infections in the immunocompromised. Prevention of endogenous infections involves suppression of the aerobic bacterial flora (selective decontamination) and measures to maintain gastrointestinal epithelial integrity to reduce risk of translocation of intestinal flora. Boosting the host immunity through passive and active immunisation should also be considered. Prevention of infection in the immunocompromised is no easy task and requires a multidisciplinary approach.
    Matched MeSH terms: Antibiotic Prophylaxis
  19. Fulltext Preference of dental practitioner on antibiotic prophylaxis for infective endocarditis guidelines: the cohort of Klang valley
    Mohd Nazrin Mohd Isa, Nor Azura Ahmad Tarmidzi, Norzalina Ghazali, Nalisha Mohamed Ramli, Ammar Yaseer Abdul Hakim@Abdul Khakin
    International Medical Journal Malaysia, 2017;16(21):9-9.
    MyJurnal
    Antibiotic prophylaxis guidelines for infective endocarditis have been regularly
    revised and modified based on current scientific evidence. These guidelines commonly regarded as
    standard of care and determine the medicolegal standards. The aim of this study was to elicit the
    current practice of prophylaxis antibiotic for Infective endocarditis among general dental
    practitioner in Klang Valley. (Copied from article).
    Matched MeSH terms: Antibiotic Prophylaxis
  20. Fulltext Post-surgical antibiotic prophylaxis: Impact of pharmacist's educational intervention on appropriate use of antibiotics
    Butt SZ, Ahmad M, Saeed H, Saleem Z, Javaid Z
    J Infect Public Health, 2019 06 10;12(6):854-860.
    PMID: 31196776 DOI: 10.1016/j.jiph.2019.05.015
    BACKGROUND: Guidelines assisted appropriate use of prophylactic antibiotics can lower the prevalence of surgical site infections (SSIs). The present study was conducted to evaluate the impact and cost-benefit value of pharmacist's educational intervention for antibiotic use in post-surgical prophylaxis.

    METHODS: A prospective quasi experimental study was conducted by enrolling 450 patients from tertiary care hospital of Lahore, Pakistan, 225 patients in each, control and intervention, arm using non-random convenient sampling. The study parameters included antibiotic indication, choice, dose, frequency, duration and associated costs. This study is registered with Chinese Clinical Trial Registry # ChiCTR-OON-17013246.

    RESULTS AND CONCLUSION: After educational intervention, in post-intervention arm, total compliance in terms of correct antibiotic choice, dose, frequency and duration increased from 1.3% to 12.4%. The rate of inappropriate antibiotic choice did not change significantly. After intervention only metronidazole utilization decreased (16%) significantly (p=0.011). Significant reductions were observed in mean duration of antibiotic prophylaxis (17%, p=0.003), average number of prescribed antibiotics (9.1%, p=0.014) and average antibiotic cost (25.7%, p=0.03), with reduction in mean hospitalization cost (p=0.003) and length of stay (p=0.023). Educational intervention was significantly associated (OR; 2.4, p=0.005) with appropriate antibiotic prophylaxis. The benefit of pharmacist intervention, mean antibiotic cost savings to mean cost of pharmacist time, was 4.8:1. Thus, the educational intervention resulted in significant reductions in the duration and average number of antibiotic use having considerable effect on therapy and hospitalization cost.

    Matched MeSH terms: Antibiotic Prophylaxis/economics; Antibiotic Prophylaxis/methods*
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