Abstract
In 2016, Ministry of Public Health’s service plan included antibiotic use in traumatic wound patients as an indicator of rational drug use. The target of this indicator was set at <40% based on a study in one large university hospital. Little is known on antibiotic use particularly in other hospital levels and regions. The objective of this study is to describe types of wounds and patterns of antibiotic use in traumatic wound patients. A prospective study was conducted in emergency unit, Mahasarakham Hospital during 1 March to 30 April 2018. The study measured types of wounds, wound classification according to antibiotic use guideline (antibiotic use is recommended for only class 2 and 3), prevalence of antibiotic use, type and duration of antibiotic use, and proportion of appropriate antibiotic use according to the guideline. Of total 267 patients, most of them were male (51.7%), had no co-morbidity (75.3%) and average age of 34+21 years. Median time from injury to hospital was 1 hour (IQR: 0.3, 3). The most common location of wound was at leg (32.2%) and wound type was animal bite (55.1%). Wound contamination was 74.5%. Prevalence of antibiotic use was 65.5%, when stratified by wound classification the prevalence was 11.1% in class 1, 72.2% in class 2 and 87% in class 3. The most common antibiotic use was Amoxycillin (62.9%). Average duration of antibiotic use was 5+1 days. According to the guideline, the rate of appropriate antibiotic use was 86.5% and appropriate duration of antibiotic use was 65.9%. In conclusion, use of antibiotics in traumatic wounds in Mahasarakham Hospital mostly adhered to the guideline but was higher than the target. Ministry of Public Health should reconsider the target of this indicator and promote further study in various hospitals and regional settings for appropriately reflecting quality of care.
