Background and Aim : Surgical Site Infections (SSIs) are among the most common HealthcareassociatedInfections (HAIs). They can result in increased antibiotic use, additional cost of illness,prolonged hospitalization, and increased patient morbidity and mortality. The goal of this study isto evaluate the appropriateness of surgical antibiotic
prophylaxis (SAP) and the microbialspectrum of SSIs in one of the biggest teaching hospitals in northeastern Iran.Methods : A hospital-based retrospective cross-sectional study was performed on all patientsadmitted to Imam Reza Hospital, Mashhad from September ۲۰۱۸ to September ۲۰۱۹, for whom atleast one event of SSI was recorded according to CDC criteria. Data obtained through chart reviewincluded demographic information, operative details (indication, site, technique, type), surgicalwound classification, surgical antibiotic
prophylaxis (regimen, timing) and microbial spectrum.Results : A total of ۸۲ patients were included (mean age ۴۳.۲±۱۵.۵). ۶۱ (۷۴.۴%) were female.Most SSI cases were seen in obstetrics and gynecology patients (۳۹.۰%). The surgical site mostcommonly associated with SSIs was the abdomen (۷۳.۲%), where the highest incidence ofinfection was seen with incisions below the umbilicus (۶۱.۷%). Cesarean section (۳۴.۱%) was theprocedure type most commonly complicated by an SSI. Most cases were seen with surgicalwounds classified as Clean (۶۲.۲%). The most commonly prescribed regimen was a combinationof ceftriaxone and metronidazole (۴۰%). Choice of antibiotic regimen and antibiotic dosage werecompatible with reference protocols in only ۴۰.۲% and ۱۹.۵% of cases, respectively. ۴۲.۷% ofpatients had received preoperative antibiotic prophylaxis, most of whom received
antibiotics morethan ۱۲۰ minutes before surgical incision (۵۴.۳%). None of the patients who underwentcardiovascular surgery, and only ۱۶.۹% of the patients who underwent other surgeries, receivedpostoperative antibiotic
prophylaxis at the appropriate time. The organism most commonlycultured from the wound site was Staphylococcus epidermidis (۲۵.۸%).Conclusion : The present study demonstrates surgical antibiotic
prophylaxis (SAP) in one of thelargest teaching medical centers in northeastern Iran to be in low compliance with referenceprotocols, suggesting the potential prevalence of the problem and the need for greater stewardshipand design of standard and reasonable local guidelines.