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.

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.

scholarly journals Saudi orthopedic surgeons’ knowledge, attitude, and practice regarding surgical antibiotic prophylaxis

2021 ◽  
Vol 0 ◽  
pp. 1-11
Author(s):  
Khalid A. Binown ◽  
Faisal A. Alhabradi ◽  
Abdulrahman M. Aljahani ◽  
Abdulaziz M. Shadid
Keyword(s):  
Saudi Arabia ◽  
Antibiotic Prophylaxis ◽  
Positive Attitude ◽  
Surgical Site Infections ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Adequate Knowledge ◽  
Orthopedic Surgeons ◽  
Surgical Antibiotic Prophylaxis

Objectives: The objectives of the study were to evaluate the knowledge, attitudes, and practice of orthopedic surgeons practicing in Saudi Arabia regarding surgical antibiotic prophylaxis (SAP). Methods: A cross-sectional study was conducted on certified and under-training orthopedic surgeons registered in the Saudi Council for Health Specialties. An email, including an online validated self-administered survey using a voluntary response sampling technique, was sent between November 2020 and January 2021. The questionnaire comprised 12 questions that tested knowledge regarding SAP, five questions that analyzed surgeon attitudes toward SAP, and three questions on SAP-related practice. Results: This study included 271 orthopedic surgeons from different areas of Saudi Arabia. The majority of respondents were registrars (or equivalent) (n = 92; 33.9%), and most of them were male (n = 257; 94.8%). Almost 95% of respondents reported that SAP was indicated for internal fixation, spinal surgeries, and prosthetic joint replacement. Moreover, 82.7% of the respondents stated that cefazolin was considered the first-line SAP. Almost 85% of the respondents demonstrated a positive attitude toward SAP, with a mean score of 2.48. However, 87.5% of them believed that adhering to SAP general guidelines would reduce the rate of infection in orthopedic surgeries. Almost 53% of respondents reported using only one guideline as a reference in their surgical practice. Moreover, 41.3% of surgeons switched between guidelines depending on the surgery. Conclusion: This study revealed adequate knowledge and a positive attitude toward SAP among orthopedic surgeons. However, a discrepancy in the practice habits of orthopedic surgeons was observed, which is explained by non-adherence to SAP protocols. Common guidelines that can be used by all orthopedic surgeons need to be developed and implemented to reduce surgical site infections and non-adherence to SAP protocols. This task can be done by a general trusted body like the Saudi Orthopedic Association.

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.

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&lt; .01); the antimicrobial regimen was adequate in 74% and 87% of patients, respectively (RR, 0.50 [95% CI, 0.45-0.55];P&lt; .01); duration of the prophylaxis was adequate in 44% and 55% of patients, respectively (RR, 0.80 [95% CI, 0.77-0.84];P&lt; .01); and the surgical site infection rates were 3.2% and 1.9%, respectively (RR, 0.59 [95% CI, 0.44-0.79];P&lt; .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&lt;.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.

scholarly journals CROSS–SECTIONAL STUDY OF SURGICAL PROPHYLACTIC ANTIBIOTIC ADMINISTRATION IN MARZOEKI MAHDI HOSPITAL, BOGOR, INDONESIA

2017 ◽  
Vol 10 (11) ◽  
pp. 87
Author(s):  
Nisa Najwa Rokhmah ◽  
Retnosari Andrajati ◽  
Maksum Radji
Keyword(s):  
Antibiotic Prophylaxis ◽  
Medical Records ◽  
Prophylactic Antibiotic ◽  
Cross Sectional Study ◽  
Antibiotic Administration ◽  
National Guidelines ◽  
Cross Sectional ◽  
Surgical Antibiotic Prophylaxis ◽  
Rational Use Of Antibiotics ◽  
Surgical Clinic

  Objective: This study was conducted to evaluate the prophylactic antibiotic administration in the surgical clinic of Dr. H. Marzoeki Mahdi Hospital, Bogor, Indonesia.Methods: The data were assessed from the medical records of all patients who underwent surgery from January to December 2013 retrospectively. Antibiotic prophylaxis was assessed based on the Scottish Intercollegiate Guidelines and the National Guidelines of Antibiotic Usage, which includes the type, time, and duration of prophylactic administration of antibiotics.Results: A total of 577 patients were included in this study, consisting of 202 men and 375 women. The most frequently performed surgery is a common surgery 347 (60.1%), followed by obstetric operations 176 (30.5%), and orthopedic surgery 54 (9.4%). In this study, all patients received prophylactic antibiotics before surgery. Cefotaxime (87.8%) was the most commonly used antibiotics for surgical prophylaxis. Of the 577 patients, only 1.1% of patients reported with surgical site infection (SSI).Conclusion: This study shows that adherence to the guidelines of surgical antibiotic prophylaxis is still very low. Therefore, efforts should be made to increase the compliance of using antibiotic prophylaxis in accordance with standard guidelines to improve the rational use of antibiotics.

Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction

2018 ◽  
Vol 159 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Michael P. Veve ◽  
Joshua B. Greene ◽  
Amy M. Williams ◽  
Susan L. Davis ◽  
Nina Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Antibiotic Prophylaxis ◽  
Head And Neck ◽  
Neck Cancer ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Cross Sectional Study ◽  
Microvascular Reconstruction ◽  
Cross Sectional

Objective To characterize and identify risk factors for 30-day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction. Study Design Cross-sectional study with nested case-control design. Setting Nine American tertiary care centers. Subjects and Methods Hospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30-day SSI; controls were patients without SSI at 30 days. Postoperative antibiotic prophylaxis (POABP) regimens were categorized by Gram-negative (GN) spectrum: no GN coverage, enteric GN coverage, and enteric with antipseudomonal GN coverage. All POABP regimens retained activity against anaerobes and Gram-positive bacteria. Thirty-day prevalence of and risk factors for SSI were evaluated. Results A total of 1307 patients were included. Thirty-day SSI occurred in 189 (15%) patients; median time to SSI was 11.5 days (interquartile range, 7-17). Organisms were isolated in 59% of SSI; methicillin-resistant Staphylococcus aureus (6%) and Pseudomonas aeruginosa (9%) were uncommon. A total of 1003 (77%) patients had POABP data: no GN (17%), enteric GN (52%), and antipseudomonal GN (31%). Variables independently associated with 30-day SSI were as follows: female sex (adjusted odds ratio [aOR], 1.6; 95% CI, 1.1-2.2), no GN POABP (aOR, 2.2; 95% CI, 1.5-3.3), and surgical duration ≥11.8 hours (aOR, 1.9; 95% CI, 1.3-2.7). Longer POABP durations (≥6 days) or antipseudomonal POABP had no association with SSI. Conclusions POABP without GN coverage was significantly associated with SSI and should be avoided. Antipseudomonal POABP or longer prophylaxis durations (≥6 days) were not protective against SSI. Antimicrobial stewardship interventions should be made to limit unnecessary antibiotic exposures, prevent the emergence of resistant organisms, and improve patient outcomes.

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 Surgical antibiotic prophylaxis use and infection prevalence in non-cosmetic breast surgery procedures at a tertiary hospital in Western Australia—a retrospective study

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5724 ◽  
Author(s):  
Ainslie Lavers ◽  
Wai Siong Yip ◽  
Bruce Sunderland ◽  
Richard Parsons ◽  
Sarah Mackenzie ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Breast Surgery ◽  
Length Of Hospital Stay ◽  
Surgical Site Infections ◽  
Tertiary Hospital ◽  
Drug Dosage ◽  
Cross Sectional Study ◽  
Infection Prevalence ◽  
Cross Sectional ◽  
The Impact

Background Surgical site infections (SSIs) are a common complication following breast surgery procedures, despite being considered a clean surgery. The prevalence of SSIs can be minimised with the appropriate use of antibiotic prophylaxis as outlined in the Australian Therapeutic Guidelines (eTG). The aims of this study were to evaluate adherence to the eTG for antibiotic prophylaxis in breast surgery procedures at a Western Australian teaching hospital following an update of the guidelines in 2014 and examine the impact of prophylactic antibiotics on SSI incidence and length of hospital stay. Method A retrospective cross-sectional study which reviewed medical records from a random sample of 250 patients selected from 973 patients who underwent breast surgical procedures between February 2015 and March 2017. Results Overall adherence to current eTG occurred in 49.2% (123/250) of operations. Pre-operative and post-operative antibiotics were prescribed in 98.4% (246/250) and 11.2% (28/250) operations respectively. Adherence rates to three specific elements of the eTG (drug prescribed, drug dosage and timing of administration) were 91.6% (229/250), 53.6% (134/250) and 86.4% (216/250) respectively. For the 14.4% (36/250) patients with relevant drug allergies, there was zero adherence to the eTG. Overall recorded SSI prevalence was low at 5.2% (13/250). The mean length of stay in patients (2.3 ± 1.7 days) was not influenced by level of eTG adherence (p = 0.131) or SSIs (p = 0.306). Conclusion These data demonstrate a significant improvement in overall adherence to the eTG from 13.3% to 49.2% (p =  < 0.001). The level of detected SSIs in this study was low. Further improvement is necessary with respect to prescribing appropriate antibiotic dosages and for those with allergies.

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