Double blind randomized controlled trial for subjects undergoing surgery receiving surgical antimicrobial prophylaxis at tertiary hospital: the clinical pharmacist's interventions

Pharmacy Practice

  • Asim Ahmed Elnour1Program of Clinical Pharmacy, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi, United Arab Emirates., 2AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates.
  • Israa Yousif Al-Khidir3University of Hail (UOH), Hail, Saudi Arabia (KSA).
  • Habab Elkheir4Department of Pharmacology, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan.
  • Abdalla Elkhawad5Department of Pharmacology, Faculty of Pharmacy, University of Medical Sciences Technology-UMST, Khartoum, Sudan.
  • Ahmed A Mohammed O6Faculty of Public Health and Health Informatics, Umm Al-Qura University, Saudi Arabia (KSA).
  • Khalid A Al-Kubaissi7Department of Pharmacy Practice & Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.
  • Ghadah Nahar8College of Pharmacy, University of Hail (UOH), Hail, Saudi Arabia (KSA).
  • Shahad Fayad Alrwili8College of Pharmacy, University of Hail (UOH), Hail, Saudi Arabia (KSA).
  • Donia Ahmed Alshelaly8College of Pharmacy, University of Hail (UOH), Hail, Saudi Arabia (KSA).
  • Amjad Saleh Alrshidi8College of Pharmacy, University of Hail (UOH), Hail, Saudi Arabia (KSA).
  • Latefa khulif Aljaber8College of Pharmacy, University of Hail (UOH), Hail, Saudi Arabia (KSA).
  • Abrar Ayad Alrashedi8College of Pharmacy, University of Hail (UOH), Hail, Saudi Arabia (KSA).

Volume 20 Issue 4 Pages 1-17

DOI: 10.18549/PharmPract.2022.4.2727

Abstract

Background: A surgical site infection (SSI) has significant clinical, humanistic and economic consequences. Surgical antimicrobials prophylaxis (SAP) is a reliable standard to prevent SSIs. Objective: The objective was to test that the clinical pharmacist's interventions may facilitate the implementation of SAP protocol and subsequent reduction of SSIs. Methods: This was double blinded randomized controlled interventional hospital-based-study at Khartoum State-Sudan. A total of 226 subjects underwent general surgeries at four surgical units. Subjects were randomized to interventions and controls in a (1:1) ratio where patient, assessors and physician were blinded. The surgical team has received structured educational and behavioral SAP protocol mini courses by way of directed lecturers, workshops, seminars and awareness campaigns delivered by the clinical pharmacist. The clinical pharmacist provided SAP protocol to the interventions group. The outcome measure was the primary reduction in SSIs. Results: There were (51.8%, 117/226) females, (61/113 interventions versus 56/113 controls), and (48.2%, 109/226) males (52 interventions and 57 controls). The overall rate of SSIs was assessed during 14 days post-operatively and was documented in (35.4%, 80/226). The difference in adherence to locally developed SAP protocol regarding the recommended antimicrobial was significant (P <0.001) between the interventions group (78, 69%) and the controls group (59, 52.2%). The clinical pharmacist's implementation of the SAP protocol revealed significant differences in SSIs with reduction in SSIs from 42.5% to 25.7% versus the controls group from 57.5% to 44.2% respectively, P = 0.001 between the interventions group and the controls group respectively. Conclusion: The clinical pharmacist's interventions were very effective in sustainable adherence to SAP protocol and subsequent reduction in SSIs within the interventions group.

Keywords

  • adherence
  • clinical pharmacist
  • randomized clinical trial
  • surgical antimicrobials prophylaxis (SAP)
  • surgical site infections (SSIs)
Pharmacy Practice

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