Antibiotic prophylaxis in an orthopaedic ward in a teaching hospital
Mathenge V.W., Mutiso V.M. Ating’a J.E.O., Otsyeno F.M.T., Awori K.O.
KNH/UON
Correspodence: venimu@yahoo.com
Introduction: It is recommended that prophylactic antibiotic be given in orthopaedic
surgery involving joint replacements and internal fixation of fractures.
Objectives: The aim of this study is to assess the current antibiotics prophylaxis practice
Setting: Firm III Orthopaedics at Kenyatta National hospital over a four weeks period March
2013.
Methods: Fifty two patients undergoing internal fixation for closed fractures and joint
replacement surgery were recruited in this prospective study. of these 49 patients(34males 15
females mean age 41.8 ± 22.8 years) who underwent internal fixation were analysed. The
choice of pre- and post-operative antibiotics, their dosages and duration of administration were
recorded. The pre-operative antibiotics were only deemed to have been given if it was
documented in the case notes and in the case of post-operative antibiotics if it was signed on
the drug chart.
Results: Sixty eight per cent were given pre-operative prophylactic antibiotics and 92% were
given post-operative antibiotics. For patients undergoing internal fixation of fractures, the
most commonly used prophylactic antibiotic was intravenous cephalosporin (57.%) however
flucloxacillin(18.2%) and benzyl penicillin(1.2%) were also used. The duration or number of
doses of postoperative antibiotics was highly variable. It was not stated in 26% of the postoperative instructions. Post- operative antibiotic was ordered for 48 hours or longer in 20%.
Conclusion: Prophylactic antibiotics appear to be widely practiced. Second generation
followed by third generation cephalosporins are the most popular antibiotics. Single dose
prophylaxis was rarely practiced. We recommend that Institutions develop and follow
Antibiotic prophylactic policies.