Usage of Prophylactic Antibiotics in Uncomplicated Gynecologic Abdominal Surgery in Siriraj Hospital
Dittakarn Boriboonhirunsarn MD, MPH, PhD*, Piyawat Lauwahutanont MD*, Kanya Kaewmanee BSc*, Monta Hangsubcharoen MNS*, Rapepan Uppagan MNS*, Supreeda Makanantakosol BNS, MPA*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University
Objective : To determine the rate of prophylactic antibiotics usage in uncomplicated gynecologic abdominal
surgery in Siriraj Hospital, before and after guideline implementation.
Materials and Methods : Two hundred and fifty-eight women who underwent elective gynecologic surgery for a
benign condition were enrolled. The patients were divided into two groups, before and after guideline imple-
mentation (control and study group). Medical records of these women were reviewed to determine the rate of
prophylactic antibiotics usage, rate of postoperative infection, and antibiotics cost.
Results : The most common prophylactic antibiotics used were Cefazolin (41.9%), Cefoxitin (36.4%), and
Augmentin (9.7%). Rate of single dose of cefazolin usage were not significantly different between the two
groups (10.1% and 12.4% respectively, p = 0.482). However, the rate of postoperative oral antibiotic usage
was significantly decreased (31.8% and 14.7% respectively, p = 0.001). The reduction of oral antibiotic usage
was significant among staff only. The rate of postoperative infection between control and study groups, as well
as between single and other antibiotic prophylaxis were similar. Had a single dose of cefazolin been adminis-
tered to all patients, the antibiotics cost would have been reduced by 102,012 Baht or 91.8%.
Conclusion : Rate of a single dose of cefazolin usage as antibiotic prophylaxis in gynecologic surgery was
similar to before guideline implementation. However, postoperative oral antibiotics usage decreased signifi-
cantly, especially among the staff.
Keywords : Prophylactic antibiotics, Gynecologic surgery
