Antibiotic use in urological surgeries: a six years review at Muhimbili National Hospital, Dar es salaam-Tanzania

Abstract

Introduction: Antimicrobial prophylaxis for urologic procedures is a major issue, as potential   advantages of antibiotic administration should be carefully weighed against potential side effects,   microbial resistance, and health care costs. This study aimed to review a six years trend of antibiotic  use  in urological surgeries at Muhimbili National Hospital (MNH) being an experience in a typical third  world environment.

Methods: This was a six years hospital based descriptive, retrospective study conducted of which all case notes of urological patients operated on in between January 2007 to December, 2012 were reviewed by using a structured data collecting tool. The data were analyzed using SPSS software.

Results: Male patients were the majority at 62% (450). The age range was 0 - 90 years, with a mean of 30 ± 22.09. Among the urological surgeries done at MNH 86.5% (628) received prophylactic antibiotics  regardless of the type surgery done. Majority 63.7% (463) received antibiotics during induction.  Ceftriaxone was the commonly given antibiotic regardless of the type of urological surgery done. Most of patients (86.4%) were given antibiotics for five days regardless whether it was for prophylactic or  treatment intention.

Conclusion: Antibiotic use is still a challenge at our hospital with over use of prophylactic antibiotics  without obvious indications. Prolonged use of prophylactic antibiotics beyond five days was the main finding. Ceftriaxone was the most given antibiotic regardless of the urological surgery done and its level of contamination. Antibiotic stewardship needs to be addressed urgently to avoid serious drug resistances leaving alone the cost implication.

Key words: Antibiotics, urological surgeries, Tanzania