Knowledge, Practice, and Compliance of Surgeons to Surgical Antibiotic Prophylaxis in Sudan: A Multicenter Cross-sectional Study

Background: Surgical site infection (SSI) is a type of healthcare-associated infection that usually occurs within 30 days postoperatively. Preoperative surgical antibiotic prophylaxis (SAP) reduces the risk of SSI. This study aims to determine surgeons’ knowledge, practice, and compliance with SAP guidelines across multiple departments.
Methods: A descriptive cross-sectional study was conducted among surgeons in multiple departments to evaluate their knowledge, practice, and compliance with SAP. A four-section questionnaire was designed and delivered to surgeons eligible for the study. The American Society of Health-System Pharmacists (ASHP) guidelines were used to classify surgeons’ responses.
Results: A total of 119 surgeons were included in this study. The majority of surgeons practiced in the general surgery department: 38 (31.9%) were general surgeons, and 72 (60.5%) were specialists. Moreover, 63 (52.9%) of the participants were male. Most participants (69, 58%) had 1–5 years of experience in surgical settings. Regarding knowledge, 113 (95%) correctly indicated that vancomycin is an appropriate choice in MRSA colonization, and 53 (44.5%) emphasized its use in cases of beta-lactam allergy. However, 62 (52.1%) incorrectly advised the use of meropenem as SAP. Regarding surgeons’ practice, significant inconsistencies were observed in the timing of SAP administration, redosing considerations, and the use of broad-spectrum antibiotics as SAP. Third-generation cephalosporin—ceftriaxone—was regarded as the first-line choice for SAP by the majority of surgeons (24.2%).
Conclusion: Although the knowledge of surgeons regarding SAP was deemed to be fair (overall noncompliance of knowledge with ASHP = 35.17%), the practice of surgeons was considered to be inadequate for guiding SAP (overall noncompliance of practice with ASHP = 53.2%). Educational interventions are needed to equip surgeons with evidence-based practices in SAP.