Introduction: The covid-19 pandemic led to an irrational increase in the use of antibiotics. Therefore, the present study aimed to investigate and compare the antibiotic prescribing pattern in surgical prophylaxis regimens before and during the covid-19 pandemic.

Methods: This cross-sectional analytical study was conducted in the gynecology department of Amiralmomenin Hospital in Semnan from 2018 to 2021. Required information, including the type of surgery, category and specific type of prescribed antibiotic, route and duration of administration, and length of hospital stay were extracted and recorded from 393 patient files. The prescribing patterns were compared against the American Society of Health-System Pharmacists (ASHP) guidelines. Data analysis was performed using SPSS version 26, employing Chi-square, Mann-Whitney U, and Bonferroni correction tests.

Results: During the pandemic period, the use of cephalosporins and the combination of cephalosporins with macrolides and nitroimidazoles significantly increased (P<0.001). Conversely, the prescription of penicillins and penicillins-tetracyclines combination significant decreased (P<0.001). In both periods, cefazolin and doxycycline have been among the most commonly prescribed antibiotics. While full compliance with ASHP guidelines was observed in terms of the type and dosage of antibiotics in both periods, non-compliance concerning the duration of therapy was higher during the pandemic (41% vs. 34%; P<0.001).

Conclusion: The Covid-19 epidemic significantly affected the antibiotic prescription pattern in surgical prophylaxis and caused a disproportionate increase in the prescription of certain antibiotics during the pandemic. Given that antimicrobial resistance has become a serious threat to global health, the appropriate application of guidelines such as ASHP is critical.