According to the Centers for Disease Control and Prevention (CDC) recommendations, antibiotic prophylaxis should only be used when necessary. The judicious use of prophylactic antibiotics, following evidence-based guidelines, leads to optimal outcomes, including reduced infection rates and the prevention of antimicrobial resistance. This study examines the practice of prophylactic antibiotic use in elective orthopedic procedures at a national teaching and referral hospital in Kenya. A prospective cross-sectional study was conducted in the orthopedic operating theaters of Kenyatta National Hospital (KNH). Participants awaiting elective orthopedic surgery were recruited using a consecutive sampling approach. Data collected from patients in the operating room included age, sex, and orthopedic specialty. Information was gathered from the treatment sheets and antibiotic prescribers. The reasons for the choice of surgical antibiotic prophylaxis were also sought from the prescribers. The collected data was analyzed using SPSS version 24. Out of 161 patients who participated in the study, cefazolin was the most commonly used antibiotic preoperatively, prescribed in 99% of cases. Eighty-seven percent of the antibiotics were administered within one hour of the start of the operation, and all were given before the application of the tourniquet. Sixteen percent of total operations involved the use of intraoperative vancomycin at the wound site. Nineteen percent of the prescribers were not aware of the hospital guidelines postoperatively. Overall, the preoperative prescribing practices of antibiotics in terms of drug choice, dosage, and timing were in line with local and international recommendations. Although the majority of prescribers were aware of the guidelines on surgical antibiotic prophylaxis (SAP), there is a need for increased sensitization regarding these guidelines among antibiotic prescribers.

 

Key words: Prophylactic antibiotics, orthopedic surgeries, surgical site infections, cefazolin, Kenyatta national hospital.