title: Antibiotic use in urological surgeries: a six years review at Muhimbili National Hospital, Dar es salaam-Tanzania.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, School of Medicine, Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Obadia
authors.initials: O
authors.lastname: Nyongole
authors.affiliation: Department of Surgery, School of Medicine, Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Larry
authors.initials: L
authors.lastname: Akoko
authors.affiliation: Department of Surgery, School of Medicine, Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Ally
authors.initials: A
authors.lastname: Mwanga
authors.affiliation: Department of Surgery, School of Medicine, Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Mabula
authors.initials: M
authors.lastname: Mchembe
authors.affiliation: Department of community Medicine, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kamala
authors.affiliation: Department of Surgery, School of Medicine, Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Naboth
authors.initials: N
authors.lastname: Mbembati
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D024881:Drug Resistance, Bacterial; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013636:Tanzania; D013997:Time Factors; D013520:Urologic Surgical Procedures / Q000379:methods*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Tanzania; urological surgeries