Surgical site infections (SSIs) remain common postoperative complications despite infection control advancements. Antibiotic prophylaxis is routinely used to reduce infection-related morbidity and mortality. However, rising antibiotic resistance, often due to inappropriate use, is a growing concern. Postoperative antibiotic upgradation is commonly practiced to combat resistance, though often without clear justification. Rational and timely antibiotic use can reduce mortality, morbidity, and healthcare costs. Yet, limited data exists on antimicrobial use and misuse in surgical inpatients. This study aims to evaluate antibiotic utilization and upgradation patterns in postoperative patients in the Department of Surgery, highlighting the need for evidence-based antimicrobial practices.

Aims and Objectives: Antibiotic prophylaxis is essential to prevent post-surgical wound infections. Rational use with appropriate upgradation can significantly reduce mortality, morbidity, and lead to substantial savings in healthcare resources.

Method: A 3-month prospective study at Gauhati Medical College included 202 post-operative patients of all ages in the post-operative care unit. Willing participants were assessed to analyze antibiotic changes after surgery, aiming to evaluate patterns and reasons for modifications in post-operative antibiotic therapy.

Result: Among 202 patients, 226 antibiotics were used. Ceftriaxone 1g was most frequently changed post-operatively, while piperacillin+tazobactam 4.5g was most commonly used. Surgical site infection (SSI) was the major reason for antibiotic change.

Conclusion: Postoperative antibiotic changes help reduce SSIs, drug reactions, and complications. This study underscores the need for monitoring prescription patterns, rational use, and timely upgrades. It advocates regular audits, antimicrobial stewardship, and adherence to guidelines to combat resistance and improve patient outcomes.