International Journal of Clinical Pharmacy

, Volume 37, Issue 1, pp 18–22 | Cite as

Clinical pharmacists’ review of surgical antimicrobial prophylaxis in a tertiary hospital in Abu Dhabi

  • Mohamed El Hassan
  • Asim Ahmed Elnour
  • Farah Hamad Farah
  • Abdulla ShehabEmail author
  • Naama M. Al Kalbani
  • Sahar Asim
  • Omer Abdulla Shehab
  • Rauda Abdulla
Short Research Report


Background There is a lack of evidence to support standard of care and concordance with surgical antimicrobial prophylaxis (SAP) guidelines in our setting. There is an opportunity for clinical pharmacists to facilitate this process across all surgical disciplines. Objective To assess adherence of surgeons to SAP guidelines. Method This was a retrospective study of 250 patients who underwent surgery during 2012 in Mafraq Hospital, Abu Dhabi. We evaluated prescribing of SAP, antimicrobial selection, first-dose timing, dose interval, treatment duration and adherence of surgeons to local hospital guidelines. Results We reviewed 250 patients (193 were male and 57 were female, mean age 36 ± 1.2 years); 54 % had elective operations and 46 % underwent emergency surgery. Adherence to hospital guidelines was 32.1 %. Antimicrobial selection, timing of the first dose, dosage interval and treatment duration were concordant with the hospital guidelines in 26, 31 and 40.3 % of cases, respectively. Main barriers to adherence to hospital guidelines were lack of awareness and education. Conclusions The present study indicated poor adherence to the SAP guidelines. The timing of administration of SAP was not appropriate in two-thirds of the patients and more than half received more than three doses of SAP inappropriately. Continuing medical education should target antimicrobial prophylaxis (selection, timing and duration), clinical pharmacy antibiotic services and cyclic auditing.


Adherence to protocol Antimicrobial surgical prophylaxis Hospital protocol Surgical site infection 



We thank all the surgical staff at Mafraq Hospital for their kind cooperation and support.


This study had no special source of funding.

Conflicts of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Awad SS. Adherence to surgical care improvement project measures and post-operative surgical site infections. Surg Infect. 2012;13(4):234–7.CrossRefGoogle Scholar
  2. 2.
    Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate point-prevalence survey of health care—associated infections. N Engl J Med. 2014;370:1198–208.PubMedCrossRefGoogle Scholar
  3. 3.
    Khan AKA, MirshAd PV, Rashed MR, Banu G. A study on the usage pattern of antimicrobial agents for the prevention of surgical site infections (SSIs) in a tertiary care teaching hospital. J Clin Diagn Res. 2013;7(4):671–4.Google Scholar
  4. 4.
    Bowater RJ, Stirling SA, Lilford RJ. Is antibiotic prophylaxis in surgery a generally effective intervention? Testing a generic hypothesis over a set of meta-analyses. Ann Surg. 2009;249(4):55156.CrossRefGoogle Scholar
  5. 5.
    Khanem JA, Khair H, Benson R. Antibiotic prophylaxis for caesarean section at Tawam Hospital, UAE. Gulf Med J. 2012;1(1):15–8.Google Scholar
  6. 6.
    Abu-Gharbieh E, Fahmy S. Adherence to surgical site infection guidelines in cardiac surgery in a tertiary hospital in Dubai, United Arab Emirates. Trop J Pharm Res. 2012;11(4):657–64.CrossRefGoogle Scholar
  7. 7.
    Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, Fish DN, Napolitano LM, Sawyer RG, Slain D, Steinberg JP, Weinstein RA. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70:195–283.PubMedCrossRefGoogle Scholar
  8. 8.
    Tourmousoglou CE, Yiannakopoulou EC, Kalapothaki V, Bramis J, Papadopoulos JS. Adherence to guidelines for antibiotic prophylaxis in general surgery: a critical appraisal. J Antimicrob Chemother. 2008;61:214–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Vessal G, Namazi S, Davarpanah MA, Foroughinia F. Evaluation of prophylactic antibiotic administration at the surgical ward of a major referral hospital, Islamic Republic of Iran. East Mediter Health J. 2011;17(8):663–8.Google Scholar
  10. 10.
    Ruiz Tovar J, Badia JM. Prevention of surgical site infection in abdominal surgery. A critical review of the evidence. Cir Esp. 2014;92(4):223–31.PubMedCrossRefGoogle Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Mohamed El Hassan
    • 1
    • 2
  • Asim Ahmed Elnour
    • 3
    • 4
  • Farah Hamad Farah
    • 5
  • Abdulla Shehab
    • 6
    Email author
  • Naama M. Al Kalbani
    • 7
  • Sahar Asim
    • 8
  • Omer Abdulla Shehab
    • 9
  • Rauda Abdulla
    • 10
  1. 1.Mafraq HospitalAbu Dhabi Health Services Company (SEHA)Abu DhabiUnited Arab Emirates
  2. 2.Medical Biology Centre, School of PharmacyQueen’s University BelfastBelfastUK
  3. 3.Al Ain HospitalAbu Dhabi Health Services Company (SEHA)Al AinUnited Arab Emirates
  4. 4.Department of Pharmacology, College of Medicine and Health SciencesUAE UniversityAl AinUnited Arab Emirates
  5. 5.College of Pharmacy and Health SciencesAjman University of Sciences and TechnologyAjmanUnited Arab Emirates
  6. 6.Department of Internal Medicine, College of Medicine and Health SciencesUAE UniversityAl AinUnited Arab Emirates
  7. 7.Tawam HospitalAbu Dhabi Health Services Company (SEHA)Abu DhabiUnited Arab Emirates
  8. 8.College of DentistryAjman University of Sciences and TechnologyAjmanUnited Arab Emirates
  9. 9.Internal Medicine Department, College of Medicine and Health SciencesUAE UniversityAl AinUnited Arab Emirates
  10. 10.College of Medicine and Health SciencesUAE UniversityAl AinUnited Arab Emirates

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