Audit of prophylactic antibiotic use in orthopaedic surgery in Mulago Hospital

Kigera JWM1 MBChB, MMed (Ortho), Turyakira C2 Dip(Orthopaedic Clinical Medicine) 1. Department of Orthopaedics, College of Health Sciences, Makerere University, Kampala, Uganda/Orthopaedic Rehabilitation Unit, PCEA Kikuyu Hospital, Kenya. 2. Mulago Paramedical Schools, Kampala, Uganda Correspondence to Kigera JWM Keywords – Antibiotics, Orthopaedic, Surgery


Background: Prophylactic antibiotics are entrenched in implant orthopaedic surgery. We conducted a study to determine the use of prophylactic antibiotics in clean implant orthopaedic surgery in Mulago hospital.


Methods: We prospectively recruited patients undergoing ORIF, Athroplasty and Foot and Ankle surgery. We obtained information on antibiotic use and observed surgeries to determine the timing of administration.


Results: Antibiotics were not used in 17.3% of patients and over half of the patients received the antibiotic after the skin incision had been made. The antibiotics were administered about 11 minutes from incision.


Conclusion: Majority of patients either did not receive antibiotics or received them after the skin incision had been made. The use of a third generation cephalosporin may be associated with increased complications and drug resistance. Antibiotic prophylaxis is in vari-ance with literature and may result in adverse outcomes.


The Annals of African Surgery is the official publication of the Surgical Society of Kenya.


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