Abstract:
Background: Surgical antimicrobial prophylaxis is the use of antibiotics before, during, or after a
surgical procedure to prevent surgical site infections which are defined as infections related to an
operative procedure that occurs at or near the surgical incision.
Objectives: To assess the use of surgical antimicrobial prophylaxis and magnitude of surgical
site infection among patients who underwent a surgical procedure in Hiwot Fana Comprehensive
Specialized Hospital, Harar, Ethiopia.
Method: Hospital based Cross-Sectional study by review of randomly selected documents from
November 1, 2022 – October 31, 2023 was used to analyze patients who underwent surgical
procedures after admission with calculated sample size being 297. The data collected from
patients’’ charts was analyzed by using SPSS version 26. Data were checked, cleaned for any
deficit before entry. Descriptive analyses and bivariate and multivariate logistic regression
analyses was done to examine the relationship between the outcome variable and predictors
Results: Surgical antimicrobial prophylaxis was administered for 96 % of patients: ceftriaxone
being the most frequently (72%) used single antimicrobial agent, with combination of
ceftriaxone and metronidazole used in 68 patients (22.9%). The diagnosis of Surgical site
infection was made in 32 patients (10.9 %) with 23 (7.74 %) having superficial type. Presence of
comorbidity (AOR= 2.85, 95% CI: 1.07–7.56, p=0.03), history of previous surgery. (AOR 3.36;
95%CI : 1.08-10.4), Preoperative ASA score two and three .(AOR 4.89; 95%CI :1.72-13.7 ) and
.(AOR 7.70; 95%CI : 1.80-32.8) respectively, emergency procedures (AOR= 3.14, 95% CI :
1.13-8.60, p=0.02) , . contaminated and dirty wound classes. (AOR 15.3; 95%CI: 2.66-88.9). and
devoid of prophylactic antibiotics (AOR 5.88; 95%CI: 1.88-18.1) were significantly associated
with development of Surgical site infection.
Conclusion: The prevalence of Surgical site infection was moderate as compared to other
Ethiopian studies with high rate of utilization of Surgical antimicrobial prophylaxis. Emergency
Surgical procedures, presence of comorbidity, contaminated and Dirty wound classes and devoid
of prophylactic antibiotics were significantly associated with surgical site infection.