Prescriptions of antibiotics in gynecological and obstetric surgery at the maternity ward of the Regional Hospital Center (CHR) in Niamey.

Research Article

Abstract

Objectives: To take stock of the prescription of antibiotics in gynecological and obstetric surgery at the maternity ward of the CHR poudrière in Niamey.

Patients and method: This is a prospective descriptive study running from March 1 ^to August 31, 2021 at the maternity ward of the CHR poudrière in Niamey. All patients who had undergone gynecological or obstetrical surgery with antibiotic prophylaxis or curative antibiotic therapy were included in the study. The variables studied were: Age, level of education, marital status, profession of the patient, history, modality and type of surgical interventions, type of anesthesia performed, duration of the intervention, postoperative monitoring, complications, methods of prescribing antibiotic prophylaxis and curative antibiotic therapy, associated treatment, and length of hospitalization. The data were entered and analyzed using Microsoft 2016 and Sphinx.v5 software.

Results: We recorded 677 patients, 563 of whom had benefited from prophylactic antibiotics, with a frequency of 83.16%, and 114 from curative antibiotic therapy, with a frequency of 16.84%. The average age was 28.59 years with extremes of 15 and 70 years. The majority of surgical interventions were performed urgently with 83.31% (n=564) and belonged to the clean surgery class in 83.16% (n=563) of cases. The average duration of surgical procedures was 40.66 minutes. The incidence of postoperative infection was 6.50% (n=47). Ceftriaxone was the molecule most used in antibiotic prophylaxis in 96.63% (n=544) of cases and in antibiotic therapy in 64.55% (n=102). For antibiotic prophylaxis, antibiotics were administered after cord clamping in all patients who underwent cesarean section and at induction in 84.10% (n=37) of cases in other surgical procedures. The duration of antibiotic prophylaxis was a maximum of 48 hours in 3.91% (n=22) and greater than 14 days of antibiotic therapy in 44.06% (n=63) of cases. The average length of stay was 3.8 days with a mortality rate of 1.18% (n=8).

Conclusion: Although the effectiveness of antibiotic prophylaxis and antibiotic therapy has been proven in gynecological and obstetric surgery, certain points should be reviewed in order to limit the occurrence of possible complications linked to their poor practices.