Appropriateness of Surgical Antibiotic Prophylaxis in Pediatric Patients in Italy

2017 ◽  
Vol 38 (7) ◽  
pp. 823-831 ◽  
Author(s):  
Mariavalentina Giordano ◽  
Lorena Squillace ◽  
Maria Pavia
Keyword(s):  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Pediatric Patients ◽  
Surgical Specialty ◽  
Inappropriate Use ◽  
Wound Contamination ◽  
Drug Choice ◽  
Surgical Antibiotic Prophylaxis ◽  
Clinical Records ◽  
Surgical Duration

OBJECTIVESAppropriate use of surgical antibiotic prophylaxis (SAP) reduces intraoperative wound contamination in pediatric surgery, thus minimizing the risk of surgical site infection (SSIs). Conversely, inappropriate use of SAP exposes patients to the risk of antibiotic side effects and contributes to the emergence of antimicrobial resistance. Our aims were to describe SAP administration and to analyze factors associated with nonadherence in pediatric patients.DESIGNDescriptive study.SETTINGOverall, 955 pediatric patients underwent 1,038 surgical procedures.METHODSWe assessed adherence to SAP international guidelines for surgical procedures performed on children aged <18 years in 2015 in 4 randomly selected hospitals in Calabria (Italy). The clinical records of these patients were retrospectively reviewed.RESULTSAppropriate SAP administration or nonadministration pertained to 754 surgical procedures (72.6%). Surgical antibiotic prophylaxis was administered in 88.5% of 358 procedures with an SAP indication. Adherence to guidelines for appropriate drug choice were followed in 5.7% of cases, for route of administration in 76.7% of cases, for timing in 48.6% of cases, for duration in 14.5% of cases, and for dose in 91.5% of cases, and for all components in only 5 cases (1.6%). Among 680 procedures without SAP indication, 35.7% case patients received antibiotics. Inappropriate administration of antibiotics in procedures without SAP indication was associated with surgical specialty wards (P=.008), ordinary admission (P<.001), head and neck surgical procedures (P=.020), clean surgery (P=.017), and surgical duration (P=.010).CONCLUSIONSDiscrepancies between SAP guidelines and actual practice behavior more frequently indicate excessive use of antibiotics than underuse. Increased awareness of SAP guidelines is required.Infect Control Hosp Epidemiol 2017;38:823–831

scholarly journals Preoperative Antibiotic Prophylaxis in Elective Minor Surgical Procedures among Adults in Southern Italy

Antibiotics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 713 ◽  
Author(s):  
Giorgia Della Polla ◽  
Aida Bianco ◽  
Silvia Mazzea ◽  
Francesco Napolitano ◽  
Italo Francesco Angelillo
Keyword(s):  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Breast Surgery ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Minor Surgical Procedures ◽  
Preoperative Antibiotic Prophylaxis ◽  
Surgical Antibiotic Prophylaxis ◽  
Prosthetic Implant

Little is known regarding the factors associated with surgical antibiotic prophylaxis (SAP) compliance in elective minor surgery. The purposes of this cross-sectional study were to identify the frequency of inappropriate SAP administration and to understand the characteristics associated with such inappropriateness in a sample of elective minor surgical procedures. The study was performed between May and July 2019 among a random sample of patients aged 18 years and older in seven public hospitals randomly selected in the Campania and Calabria Regions of Italy. Globally, only 45% of SAP approaches were deemed completely in accordance with the evidence-based guidelines. Patients with an ordinary admission, those who underwent local anesthesia, those receiving plastic and reconstructive and ophthalmology surgery, and those who had not received a prosthetic implant were more likely to receive an appropriate SAP approach; those receiving obstetrics, gynecological, and urological surgical procedures were less likely than those who underwent abdominal, vascular, and breast surgery. The course of antibiotic prophylaxis was not consistent with the guidelines in 48.5% procedures with one or more reasons for inappropriateness. Appropriate time of the SAP administration was more frequently observed in patients who were older, those with a Charlson comorbidity index of 0, those who did not receive a prosthetic implant, and those receiving plastic and reconstructive surgery; it was less likely in patients receiving obstetrics, gynecological, and urological surgeries compared with those who underwent abdominal, vascular, and breast surgery. Aspects of SAP that need to be improved are molecule choice, time of administration, and specific surgical procedures. Hospital managers should involve surgeons and anesthesiologists in initiatives tailored to optimize SAP prescribing.

Adherence to American Society of Health-System Pharmacists Surgical Antibiotic Prophylaxis Guidelines in Iran

2006 ◽  
Vol 27 (08) ◽  
pp. 876-878 ◽  
Author(s):  
Mehrdad Askarian ◽  
Ali Reza Moraweji ◽  
Hossein Mirkhani ◽  
Soha Namazi ◽  
Harrison Weed
Keyword(s):  
Health System ◽  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Medical Records ◽  
Teaching Hospitals ◽  
Surgical Antibiotic Prophylaxis ◽  
American Society

We assessed the appropriateness of surgical antibiotic prophylaxis in 6 teaching hospitals in Shiraz, Iran, using the American Society of Health-System Pharmacists guideline as a reference. We reviewed the medical records of 1,000 patients who underwent 1 of 9 different surgical procedures (1 procedure per patient). The proportion of procedures in which there was compliance with all guideline recommendations was 0.3%. The most common mistakes were overuse and misuse of antibiotics.

scholarly journals Preoperative antibiotic prophylaxis practice and guideline adherence in Jordan: a multi-centre study in Jordanian hospitals

2012 ◽  
Vol 6 (10) ◽  
pp. 715-720 ◽  
Author(s):  
Sayer I Al-Azzam ◽  
Karem H Alzoubi ◽  
Nizar M Mhaidat ◽  
Rania D Haddadin ◽  
Majed M Masadeh ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Antimicrobial Agents ◽  
Antimicrobial Prophylaxis ◽  
Surgical Site Infections ◽  
Cross Sectional Study ◽  
Intravenous Route ◽  
Cross Sectional ◽  
Multi Centre Study ◽  
Surgical Antibiotic Prophylaxis

Introduction: The use of antimicrobial prophylaxis for surgical procedures is one of the measures employed to prevent the development of surgical site infections (SSI). The appropriate choice of antimicrobial agents, dosage regimen, timing, duration and use of intravenous route must be evidence based. This study aimed to assess the practice of surgical antibiotic prophylaxis and adherence of practitioners to the American Society of Health-System Pharmacists (ASHP) guidelines for antimicrobial prophylaxis in surgery and to explore reasons for non-compliance. Methodology: A cross-sectional study was conducted in 20 Jordanian hospitals from October 2006 to June 2007. A questionnaire was designed to collect information from physicians regarding the practice of surgical antibiotic prophylaxis (SAP), references used for guiding SAP practice, prevalence of surgical site infection (SSI), and causative microorganisms. Results: SAP was employed in almost all surgical departments of hospitals. The improper timing of antimicrobial administration for SAP was attributed to lack of knowledge of the guidelines (46.1%), while the improper antimicrobial choice was ascribed to drug unavailability (61.8%). Conclusion: This study shows that physicians are aware of the importance of antimicrobial prophylaxis before surgical procedures. However, further efforts are needed to ensure the implementation of the standard SAP guidelines in Jordanian hospitals.

A National Survey of Surgical Antibiotic Prophylaxis in Turkey

2003 ◽  
Vol 24 (10) ◽  
pp. 758-761 ◽  
Author(s):  
Salih Hosoglu ◽  
Mustafa Sunbul ◽  
Serpil Erol ◽  
Mustafa Altindis ◽  
Rahmet Caylan ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
University Hospitals ◽  
Surgical Prophylaxis ◽  
Cross Sectional ◽  
Elective Surgical Procedures ◽  
Surgical Antibiotic Prophylaxis ◽  
Clean Contaminated

AbstractObjective:To assess the quality of antibiotic prophylaxis for clean and clean-contaminated elective surgical procedures.Design:A cross-sectional, country-wide survey.Setting:Thirty-six hospitals in 12 cities in Turkey.Participants:Four hundred thirty-nine surgeons from 6 different specialties who performed selected procedures of interest.Methods:A random sample of surgeons from different hospitals was selected. A standardized data collection form was used to record the type of procedure, the names, doses, timing of the first doses, and duration of antibiotics, important decisive factors, and problems in the management of prophylactic antibiotic use for surgical procedures.Results:Fifty-five percent of surgeons addressed completed the survey. For clean-contaminated procedures, 6% of surgeons did not use antibiotic prophylaxis, whereas 88% used more than a single dose. Inappropriate antibiotics were chosen for 32% of procedures. In 39% of procedures, the first dose of antibiotics was not administered during induction of anesthesia. Duration of prophylaxis was longer than 24 hours in 80% and longer than 48 hours in 46% of all procedures. Only 112 surgeons (26%) were using definitely appropriate prophylaxis in all ways. Multivariate analysis revealed that surgeons in university hospitals (OR, 2.353; CI95, 1.426–3.884; P = .001) and general surgeons (OR, 4.986; CI95, 2.890–8.604; P < .001) used antibiotic prophylaxis more appropriately. Patients not covered by health insurance (OR, 0.417; CI95, 0.225–0.772; P < .001) were associated with inappropriate prophylaxis.Conclusion:Given the high frequency of antibiotics prescribed for surgical prophylaxis in Turkey, adherence to surgical prophylaxis guidelines is urgently needed.

scholarly journals Impact of Narrow vs. Broad-Spectrum Surgical Antibiotic Prophylaxis in Pediatric Patients with Enteral Tubes Undergoing Cardiac Surgery

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S652-S652
Author(s):  
Kelly B Flett ◽  
Jane Carpenter ◽  
Gail Potter-Bynoe ◽  
Deborah Morrow ◽  
Shaila Murji ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Antibiotic Prophylaxis ◽  
Broad Spectrum ◽  
Pediatric Patients ◽  
Surgical Antibiotic Prophylaxis

scholarly journals Assessment of implementation of antibiotic stewardship program in surgical prophylaxis at a secondary care hospital in Ras Al Khaimah, United Arab Emirates

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hessa Saleh Alshehhi ◽  
Areeg Anwer Ali ◽  
Duaa Salem Jawhar ◽  
Essam Mahran Aly ◽  
Srinivas Swamy ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
United Arab Emirates ◽  
Antibiotic Stewardship ◽  
Secondary Care ◽  
Care Hospital ◽  
Surgical Prophylaxis ◽  
Patient Profile ◽  
Stewardship Program ◽  
Prescribing Practice ◽  
Surgical Antibiotic Prophylaxis

AbstractAntibiotic overuse is a major factor for causing antibiotic resistance globally. However, only few studies reported the implementation and evaluation of antimicrobial stewardship programs in Gulf Cooperation Council. This study was conducted within 8-months periods to evaluate the effect of the newly implemented antibiotic stewardship program on improving the prescribing practice of surgical antibiotic prophylaxis in a secondary care hospital in the United Arab Emirates by releasing local hospital guidelines. The data of 493 in patients were documented in the predesigned patient profile form and the prescribing practice of surgical antibiotic prophylaxis for clean and clean-contaminant surgical procedures was compared and analyzed two months’ prior (period A) and post (period B) the implementation of antibiotic stewardship program. The 347 patient’s data (PD) were analyzed during period A and 146 PD during period B. The prescription of piperacillin/tazobactam was decreased from 2.4% from all surgical prophylaxis antibiotic orders in period A to 0% in period B. The appropriateness of the antibiotic therapy was found to differ non significantly for the selection of prophylactic antibiotic (p = 0.552) and for the timing of first dose administration (p = 0.061) between A and B periods. The total compliance was decreased non significantly (P = 0.08) from 45.3 to 40.2%. Overall, the guidelines have improved the prescribing practice of antibiotics prior to surgery. However, further improvement can be achieved by initiating educational intervention via cyclic auditing strategy.

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