4CPS-031 Audit of antibiotic prophylaxis practice in visceral surgery in an African country

Background and importance According to the WHO, care associated infections (CAIs) affect at least 2 million patients worldwide annually. In this African country, common CAIs are surgery site infections (SSI; 24.7% among inpatients in the south of the country). To prevent SSIs, appropriate use of antibiotics is essential. Aim and objectives To audit compliance with international recommendations of antibioprophylaxis practices in visceral surgery. Material and methods Data were prospectively collected in visceral surgery wards of five hospitals. Compliance with the antibiotic indication (administered when needed and not administered when not required), choice of molecule, dosage, timing of administration and duration were assessed in patients admitted for class 1 or 2 surgery according to Altemeier’s classification over 4 months. The international recommendation on antibiotic prophylaxis described by the SFAR (Societe Francaise d’ Anesthesie et Reanimation)1 was considered as a reference. Statistical analysis was performed using SPSS software. Results A total of 71 interventions were included the study. In 50 cases (70.4%), the administration conformed to the indication criteria (ie, 48 administrations when actually indicated and 2 abstentions when antibioprophylaxis was not required). None (0%) of the 48 patients who received the indicated antibioprophylaxis were administered the recommended molecule. Ceftriaxone was the most widely used molecule (31%). In addition, the initial dose, timing and duration of antibiotic treatment were in accordance with SFAR standards in 35%, 14% and 21% of cases, respectively. Conclusion and relevance This study highlights a problem of compliance with recommendations. This can be partly explained by the unavailability of half of the recommended molecules in the local market, the urgent character of the surgery and the lack of knowledge and training of health staff. The overuse of broad spectrum antibiotics reported in other studies may reveal a fear of SSIs by healthcare providers. These data underline the need for implementing an appropriate antibioguide based on local epidemiology and drug availability. References and/or acknowledgements 1. SFAR. Antibioprophylaxie en chirurgie et medecine interventionnelle. Reactualisation 2018;2018:1–31 [En ligne] www.cpias.fr/nosobase/.../Antibioprophylaxie-RFE-mise-a-jour-2018.pdf We thank the Academie de Recherche et d’Enseignement Superieur (ARES) for funding this work. No conflict of interest.