Audit of Prophylactic Antibiotic Use in Orthopaedic Surgery in Mulago Hospital

Background: Prophylactic antibiotics are entrenched in implant orthopaedic surgery. We conducted a study to determine the use of prophylactic antibiotics in clean implant orthopaedic surgery in Mulago hospital. Methods: We prospectively recruited patients undergoing ORIF, Athroplasty and Foot and Ankle surgery. We obtained information on antibiotic use and observed surgeries to determine the timing of administration. Results: Antibiotics were not used in 17.3% of patients and over half of the patients received the antibiotic after the skin incision had been made. The antibiotics were administered about 11 minutes from incision. Conclusion: Majority of patients either did not receive antibiotics or received them after the skin incision had been made. The use of a third generation cephalosporin may be associated with increased complications and drug resistance. Antibiotic prophylaxis is in variance with literature and may result in adverse outcomes.