The National Centre for Disease Control (NCDC) has recommended limiting antibiotic use to a single dose or the day before the procedure to prevent infections at the surgical site. According to a recent report released by the NCDC, antibiotics need to be administered post-surgery only if there is confirmation of any infection.
The NCDC, which is a government agency, had recently conducted a multi-centric survey. It was concluded in the survey that the majority of inpatients are prescribed antibiotics for multiple days to prevent infection at the surgical site.
The survey was conducted at 20 hospitals across India, and 12,000 prescriptions were taken into consideration. This study was conducted between November 2021 and April 2022 under the aegis of the National Programme for Antimicrobial Containment. The survey involved the observation of patients who underwent surgical prophylaxis. Based on the administration of antibiotics for the prevention of surgical infections, the patients were categorized into three groups. The administration of antibiotics within the previous 24 hours was observed and categorized as S for a single dose, SP2 for multiple doses in a single day, and SP3 for multiple days. The researchers concluded that 91% of patients were prescribed SP3, 8% SP2, and only 1% fell into the category of S.
It is a common methodology to put patients opting for surgery on antibiotics in a bid to prevent infections. It has been proven in several studies that prolonged intake of antibiotics to prevent infections is ineffective in preventing infections. Moreover, it showed an increase in antimicrobial resistance.
In 2022, the Indian Council of Medical Research (ICMR) had issued an advisory stating that several studies have suggested the effectiveness of perioperative antibiotic prophylaxis is only for 12 hours or less.
The NCDC recommended that hospitals and surgeons need to adhere to standard treatment guidelines. They need to have a defined antibiotic policy, ensure that the reserve group of antibiotics is minimally used, and avoid the use of multiple antibiotics. Experts also suggested that the state government be vigilant for hospitals that provide free medicines and conduct microbial cultures when prescribing antibiotics.
(Inputs from various sources)
(Rehash/Dr. Sushmita Ganguli)
