A Study on the Assessment of Etiological Factors of Laparotomy and Its Drug Utilization Evaluation Along With Ceftriaxone Resistance
Main Article Content
Abstract
Aims and objectives: To study and analyse the prescription pattern of drugs post-laparotomy surgery, etiological factors of laparotomy surgery, and ceftriaxone resistance in the study population.
Materials and method: A prospective observational study of patients who underwent laparotomy surgery was carried out in the surgery department of K R Hospital, Mysuru for a period of six months. All relevant data of the enrolled patients was collected from various data sources and documented in suitably designed data collection forms to evaluate the causes of laparotomy and to understand the pattern and extent of medication by using Drug Utilization and Evaluation(DUE). The reports of blood cultures, wound cultures, or pus cultures of study participants will be evaluated to check for ceftriaxone resistance.
Results: Of 103 patients, 64.1% were male and 35.9% were female. Most patients were in the age group 31-40 years (29.1%). In this study, the most commonly prescribed class of drugs were Analgesics 21.9% (n=158), followed by Electrolytes 16.8% (n=121), Antibiotics 15.9% (n=103), PPI 14.3% (n=103) respectively. The most common etiological factors of laparotomy surgery were acute appendicitis 44.66% (n=46), acute intestinal obstruction 13.58% (n=14), and subacute intestinal obstruction 9.70% (n=10). Out of 103patients, 12 patients underwent a culture sensitivity test and 58.33% (n=7) were resistant to ceftriaxone.
Conclusion: Gender and age of the study population had a significant association with the study and were majorly considered. The study observed that the strains of organisms that exhibit resistance to ceftriaxone are gram-negative bacteria Escherichia coli and gram-negative bacteria Pseudomonas aeruginosa. The most commonly used drugs were Analgesics, Electrolytes, Antibiotics, and PPI. Major etiological factors for performing laparotomy surgery were found to be acute appendicitis, acute intestinal obstruction, and sub-acute intestinal obstruction.
References
Rajaretnam N, Okoye E, Burns B.
Laparotomy. StatPearls Publishing; 2023.
Laparotomy – Cleveland Clinic.
https://www.ncbi.nlm.nih.gov/books/NBK525961/
Ahmed A, Azim A.
Emergency laparotomies: Causes, Pathophysiology, and Outcomes.
Indian J Crit Care Med. 2020;24(Suppl 4):S183–S189.
Jackson PG, Raiji MT.
Evaluation and management of intestinal obstruction.
Am Fam Physician. 2011;83(2):159–165.
Hafner J, Tuma F, Hoilat GJ, Marar O.
Intestinal Perforation. StatPearls Publishing; 2022.
Jones MW, Lopez RA, Deppen JG.
Appendicitis. StatPearls Publishing; 2023.
Peritonitis – Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/17831-peritonitis
Reich H, Chou D, Melo N.
Perforated hollow viscus. In: McGraw Hill Medical.
Pooria A, Pourya A, Gheini A.
A descriptive study on the usage of exploratory laparotomy for trauma patients.
Open Access Emerg Med. 2020;12:255–260.
Madubogwu CI.
Exploratory laparotomy in a single center general surgery unit: indications and outcome.
Ajol.info
Sorate Y, Joshi D, Pawar S, et al.
A prospective study of laparoscopic appendicectomy for the treatment of acute appendicitis.
MVP J Med Sci. 2018;5(1):21–25.
Appendectomy – Cleveland Clinic.
Exploratory laparotomy – Saint Luke’s Health System.
https://www.saintlukeskc.org/health-library/exploratory-laparotomy
Alemkere G.
Antibiotic usage in surgical prophylaxis: A prospective observational study in the surgical ward of Nekemte referral hospital.
PLoS One. 2018;13(9):e0203523.
Waaseth M, Adan A, Røen IL, Eriksen K, Stanojevic T, Halvorsen KH, et al.
Knowledge of antibiotics and antibiotic resistance among Norwegian pharmacy customers – a cross-sectional study.
BMC Public Health. 2019;19(1).
Ayele AA, Gebresillassie BM, Erku DA, Gebreyohannes EA, Demssie DG, Mersha AG, et al.
Prospective evaluation of Ceftriaxone use in medical and emergency wards of Gondar University referral hospital, Ethiopia.
Pharmacol Res Perspect. 2018.
Karger.com.
https://karger.com/vis/article/38/5/345/827246/The-Need-of-Antimicrobial-Stewardship-in-Post
Geroulanos S, Marathias K, Kriaras J, Kadas B.
Cephalosporins in surgical prophylaxis.
J Chemother. 2001;13(sup4):23–26.
Bui T, Preuss CV.
Cephalosporins. StatPearls Publishing; 2023.
Sadeeqa S.
Appropriate surgical prophylaxis using ceftriaxone.
Virol Immunol J. 2019;3(2).
Gelaw LY, Bitew AA, Gashey EM, Ademe MN.
Ceftriaxone resistance among patients at GAMBY Teaching General Hospital.
Sci Rep. 2022;12(1).
Mittal N, Mittal R, Singh I, Shafiq N, Malhotra S.
Drug utilization study in a tertiary care center: recommendations for improving hospital drug dispensing policies.
Indian J Pharm Sci. 2014;76(4):308–314.
Gangwar R, Kumar A, Zargar AA, Sharma A, Kumar R.
The role of drug utilization evaluation in medical sciences.
Glob Health J. 2023;7(1):3–8.
Prasath X.
A prospective study of emergency laparotomies among patients attending Chengalpattu Medical College.
Chengalpattu Medical College; 2014.
Manoj P, Shashikumar HB, Gangamma K.
Post-operative complication rates in patients undergoing emergency laparotomy in tertiary care hospital.
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.