scholarly journals Changing Surgical Antimicrobial Prophylaxis Practices through Education Targeted at Senior Department Leaders

1990 ◽  
Vol 11 (11) ◽  
pp. 578-583 ◽  
Author(s):  
Daniel E. Everitt ◽  
Stephen B. Soumerai ◽  
Jerry Avorn ◽  
Henry Klapholz ◽  
Michael Wessels
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Department Leaders ◽  
Surgical Antimicrobial Prophylaxis

scholarly journals Intraoperative Bacterial Contamination and Activity of Different Antimicrobial Prophylaxis Regimens in Primary Knee and Hip Replacement

Antibiotics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 18
Author(s):  
Alba Rivera ◽  
Alba Sánchez ◽  
Sonia Luque ◽  
Isabel Mur ◽  
Lluís Puig ◽  
...  
Keyword(s):  
Hip Replacement ◽  
Bacterial Contamination ◽  
Antimicrobial Prophylaxis ◽  
Coagulase Negative Staphylococci ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Total Knee ◽  
Surgical Antimicrobial Prophylaxis ◽  
Almost All

Surgical antimicrobial prophylaxis (SAP) is important for the prevention of prosthetic joint infections (PJIs) and must be effective against the microorganisms most likely to contaminate the surgical site. Our aim was to compare different SAP regimens (cefazolin, cefuroxime, or vancomycin, alone or combined with gentamicin) in patients undergoing total knee (TKA) and hip (THA) arthroplasty. In this preclinical exploratory analysis, we analyzed the results of intraoperative sample cultures, the ratio of plasma antibiotic levels to the minimum inhibitory concentrations (MICs) for bacteria isolated at the surgical wound and ATCC strains, and serum bactericidal titers (SBT) against the same microorganisms. A total of 132 surgical procedures (68 TKA, 64 THA) in 128 patients were included. Cultures were positive in 57 (43.2%) procedures (mostly for coagulase-negative staphylococci and Cutibacterium spp.); the rate was lower in the group of patients receiving combination SAP (adjusted OR 0.475, CI95% 0.229–0.987). The SAP regimens evaluated achieved plasma levels above the MICs in almost all of intraoperative isolates (93/94, 98.9%) and showed bactericidal activity against all of them (SBT range 1:8–1:1024), although SBTs were higher in patients receiving cefazolin and gentamicin-containing regimens. The potential clinical relevance of these findings in the prevention of PJIs remains to be determined.

Quality of local guidelines for surgical antimicrobial prophylaxis

2004 ◽  
Vol 56 (1) ◽  
pp. 67-70 ◽  
Author(s):  
C Gagliotti ◽  
F Ravaglia ◽  
D Resi ◽  
M.L Moro
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Surgical Antimicrobial Prophylaxis

scholarly journals Optimal timing of surgical antimicrobial prophylaxis in laparoscopic surgery: a before-after study

2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Akane Takamatsu ◽  
Yasuaki Tagashira ◽  
Kaori Ishii ◽  
Yasuhiro Morita ◽  
Yasuharu Tokuda ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Antimicrobial Prophylaxis ◽  
Optimal Timing ◽  
Surgical Antimicrobial Prophylaxis

Reduction in Surgical Antibiotic Prophylaxis Expenditure and the Rate of Surgical Site Infection by Means of a Protocol That Controls the Use of Prophylaxis

2006 ◽  
Vol 27 (12) ◽  
pp. 1358-1365 ◽  
Author(s):  
Marisa I. Gómez ◽  
Silvia I. Acosta-Gnass ◽  
Luisa Mosqueda-Barboza ◽  
Juan A Basualdo
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Final Stage ◽  
Antimicrobial Prophylaxis ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Infection Rates ◽  
Prospective Survey ◽  
Surgical Antibiotic Prophylaxis ◽  
Surgical Antimicrobial Prophylaxis

Objective.To evaluate the effectiveness of an intervention based on training and the use of a protocol with an automatic stop of antimicrobial prophylaxis to improve hospital compliance with surgical antibiotic prophylaxis guidelines.Design.An interventional study with a before-after trial was conducted in 3 stages: a 3-year initial stage (January 1999 to December 2001), during which a descriptive-prospective survey was performed to evaluate surgical antimicrobial prophylaxis and surgical site infections; a 6-month second stage (January to June 2002), during which an educational intervention was performed regarding the routine use of a surgical antimicrobial prophylaxis request form that included an automatic stop of prophylaxis (the “automatic-stop prophylaxis form”); and a 3-year final stage (July 2002 to June 2005), during which a descriptive-prospective survey of surgical antimicrobial prophylaxis and surgical site infections was again performed.Setting.An 88-bed teaching hospital in Entre Ríos, Argentina.Patients.A total of 3,496 patients who underwent surgery were included in the first stage of the study and 3,982 were included in the final stage.Results.Comparison of the first stage of the study with the final stage revealed that antimicrobial prophylaxis was given at the appropriate time to 55% and 88% of patients, respectively (relative risk [RR], 0.27 [95% confidence interval {CI}, 0.25-0.30]; P < .01); the antimicrobial regimen was adequate in 74% and 87% of patients, respectively (RR, 0.50 [95% CI, 0.45-0.55]; P < .01); duration of the prophylaxis was adequate in 44% and 55% of patients, respectively (RR, 0.80 [95% CI, 0.77-0.84]; P < .01); and the surgical site infection rates were 3.2% and 1.9%, respectively (RR, 0.59 [95% CI, 0.44-0.79]; P < .01). Antimicrobial expenditure was US$10,678.66 per 1,000 patient-days during the first stage and US$7,686.05 per 1,000 patient-days during the final stage (RR, 0.87 [95% CI, 0.86-0.89]; P<.01).Conclusion.The intervention based on training and application of a protocol with an automatic stop of prophylaxis favored compliance with the hospital's current surgical antibiotic prophylaxis guidelines before the intervention, achieving significant reductions of surgical site infection rates and substantial savings for the healthcare system.

Surgical antimicrobial prophylaxis in transurethral ureterolithotripsy

2005 ◽  
Vol 11 (5) ◽  
pp. 239-243 ◽  
Author(s):  
Satoshi Takahashi ◽  
Koh Takeyama ◽  
Shintaro Miyamoto ◽  
Yasushi Tanuma ◽  
Yoshio Takagi ◽  
...  
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Surgical Antimicrobial Prophylaxis

Clinical practice guidelines for surgical antimicrobial prophylaxis: Qualitative appraisals and synthesis of recommendations

2018 ◽  
Vol 25 (4) ◽  
pp. 591-602 ◽  
Author(s):  
Sheila Kalb Wainberg ◽  
Nathalia Celini Leite Santos ◽  
Franciele Cordeiro Gabriel ◽  
Luciana Pereira de Vasconcelos ◽  
Jéssica Santos Nascimento ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Antimicrobial Prophylaxis ◽  
Surgical Antimicrobial Prophylaxis

Meta-analysis of the efficacy of ertapenem in preventing SSIs after elective colorectal surgery

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Vicentini ◽  
A Corradi ◽  
S Corcione ◽  
F G De Rosa ◽  
C M Zotti
Keyword(s):  
Colorectal Surgery ◽  
Antimicrobial Prophylaxis ◽  
Meta Analysis ◽  
Carbapenem Resistance ◽  
Surgical Site Infections ◽  
Resistant Isolate ◽  
Elective Colorectal Surgery ◽  
Surgical Antibiotic Prophylaxis ◽  
Surgical Antimicrobial Prophylaxis ◽  
Reported Data

Abstract Background The efficacy of standard surgical antimicrobial prophylaxis (SAP) regimens in preventing surgical site infections (SSIs) after colorectal surgery is declining, along with rising rates of intestinal colonization with antimicrobial resistant (AMR) Enterobacteriaceae and Bacteroides spp. Ertapenem has been approved by the FDA and EMA for SAP in this context, however it has not been used extensively for this indication out of concern for increasing carbapenem-resistance rates. A limited number of studies have investigated the efficacy of ertapenem in preventing SSIs after colorectal surgery, comparing ertapenem with different agents or combinations of agents. Methods A systematic review was conducted following the PRISMA checklist. PubMed, Embase and Cochrane databases were searched for studies measuring the efficacy of ertapenem in preventing SSIs following elective colorectal procedures. Studies were considered eligible if they reported extractable data on the proportion of SSIs and/or on the proportion of AMR pathogens isolated from SSIs. Data from all ertapenem study arms were extracted. A random effects meta-analysis was performed to estimate the overall proportion of SSI. Results Of 1109 identified studies, 5 met the inclusion criteria and were included in the meta-analysis, totalling 3176 participants. The pooled proportion of SSI was 0.10 (95% CI 0.05-0.18; I2=96%; τ2=0.6323; p ≤ 0.01). Only one study reported data on carbapenem resistance: out of 124 isolates from 30 patients, 1 gram negative carbapenem-resistant isolate was identified. Conclusions The pooled proportion of SSI using ertapenem as SAP found in this study is in line with the proportion of SSI using standard SAP found by a recent meta-analysis (Gandra, 2019). According to this analysis, the benefit of ertapenem does not outweigh the risk of further promoting AMR, although results should be interpreted with caution due to the high heterogeneity among included studies. Key messages According to this study, the efficacy of ertapenem in preventing surgical site infections after elective colorectal surgery is comparable to the efficacy of standard surgical antibiotic prophylaxis. The emergence of carbapenem resistance after surgical prophylaxis with ertapenem should be further investigated through longer term studies before widespread use for this indication.

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