title: Need of improvement in timing of prophylactic antibiotic in elective surgery.
abstract: BACKGROUND
  Infections in surgery are major concern of morbidity, mortality, and costs. Timely antibiotic prophylaxis before incision ensures optimum concentration of AP in blood and tissues to prevent surgical site infections . However, proper timing of AP remains problematic as reported by various studies, though none so far from Nepal. Aim of this prospective observational study was to assess and address the issues for improvements in timing of AP.
  
  
  METHODS
  The pattern of antibiotic prophylaxis were prospectively collected in respect to time of induction, and incision time were recorded on predesigned 'AP form'. The study included all the elective major cases who received AP of intravenous Cefazoline 1 g as per our existing protocol. The emergency surgeries and obstetric cases were excluded from the study.
  
  
  RESULTS
  There were 125 cases of which 89% received AP before incision (63% within 5 minutes before incision), while 11% had AP after the incision and 1% within the recommended time period of 2 hour to 30 minutes before incision.
  
  
  CONCLUSIONS
  Current practice of antibiotic prophylaxis (AP) needs improvement as per standard guidelines of AP within 2 hour to 30 before incision.
authors: Department of surgery, Patan Hospital, Patan Academy of Health Science (PAHS), Lalitpur, Nepal. drjaywufei@hotmail.com
authors: J N
authors: JN
authors: Shah
authors: S B
authors: SB
authors: Maharjan
authors: R
authors: R
authors: Piya
authors: A
authors: A
authors: Shrestha
authors: K
authors: K
authors: Shrestha
authors: N B
authors: NB
authors: Basnet
authors: H M
authors: HM
authors: Gurung
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000592:standards*; D002437:Cefazolin / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D009390:Nepal; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin