The impact of low-dose versus high-dose antibiotic prophylaxis regimens on surgical site infection rates after cesarean delivery

2019 ◽  
Vol 301 (1) ◽  
pp. 69-73 ◽  
Author(s):  
Mauricio La Rosa ◽  
Chasey Omere ◽  
Tiffany Redfern ◽  
Mahmoud Abdelwahab ◽  
Nicholas Spencer ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Cesarean Delivery ◽  
Low Dose ◽  
High Dose ◽  
Site Infection ◽  
Infection Rates ◽  
The Impact

scholarly journals 411: The impact of low dose versus high dose antibiotic prophylaxis regimens on surgical site infection rates after cesarean delivery

2017 ◽  
Vol 216 (1) ◽  
pp. S244-S245
Author(s):  
Mauricio La Rosa ◽  
Chasey Omere ◽  
Tiffany Redfurn ◽  
Mahmoud Abdelwahab ◽  
Nicholas Spencer ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Cesarean Delivery ◽  
Low Dose ◽  
High Dose ◽  
Site Infection ◽  
Infection Rates ◽  
The Impact

58 Use of Abdominal Wall or Sucutaneous Drain to Reduce the Risk of Surgical Site Infections

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Mistry ◽  
B Woolner ◽  
A John
Keyword(s):  
Surgical Site Infection ◽  
Open Cholecystectomy ◽  
Surgical Site Infections ◽  
Standard Operating Procedure ◽  
Site Infection ◽  
Infection Rates ◽  
Local Evidence ◽  
Audit Data ◽  
The Impact ◽  
To Receive

Abstract Introduction Open abdominal surgery confers potentially greater risk of surgical site infections, and local evidence suggests use of drains can reduce this. Our objectives were: Assessing local rates and risk factors of infections and if use of drains can reduce the rates of infections. Method Retrospectively looking from 01/01/2018 to 31/12/2018, at patients following laparotomy or open cholecystectomy. Data collection on demographics, smoking/alcohol status, heart, respiratory or renal disease or diabetes, steroid use and CEPOD status, as well as use of drain and the outcome of infection using inpatient and online patient records. Results 84 patients included, 25 had drains inserted. There were 13 documented cases of surgical site infection, all of whom had no drain post-op. Other parameters shown to be most prevalent in the patients with a surgical site infection include being current/ex-smoker (8/13), having heart disease (9/13), and elective procedures. Conclusions Aiming to reduce the risk of surgical site infections can improve morbidity and potentially mortality outcomes. Our audit data showed that there appears to be a benefit of inserting intra-abdominal or subcutaneous drains. We will create a standard operating procedure of all patient to receive drains post-op and then re-audit to assess the impact this has on infection rates.

scholarly journals Standardising intraoperative irrigation with 0.05% chlorhexidine gluconate in caesarean delivery to reduce surgical site infections: A single institution experience

2019 ◽  
Vol 30 (1-2) ◽  
pp. 24-33
Author(s):  
Theresa Mangold ◽  
Erin Kinzel Hamilton ◽  
Helen Boehm Johnson ◽  
Rene Perez
Keyword(s):  
Treatment Group ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Caesarean Delivery ◽  
Chlorhexidine Gluconate ◽  
Control Group ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Infection Rates ◽  
The Impact

Background Surgical site infection is a significant cause of morbidity and mortality following caesarean delivery. Objective To determine whether standardising intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery could decrease infection rates. Methods This was a process improvement project involving 742 women, 343 of whom received low-pressured 0.05% chlorhexidine gluconate irrigation during caesarean delivery over a one-year period. Infection rates were compared with a standard-of-care control group (399 women) undergoing caesarean delivery the preceding year. Results The treatment group infection rate met the study goal by achieving a lower infection rate than the control group, though this was not statistically significant. A significant interaction effect between irrigation with 0.05% chlorhexidine gluconate and antibiotic administration time existed, such that infection occurrence in the treatment group was not dependent on antibiotic timing, as opposed to the control group infection occurrence, which was dependent on antibiotic timing. Conclusion Intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery did not statistically significantly reduce the rate of infections. It did render the impact of antibiotic administration timing irrelevant in prevention of surgical site infection. This suggests a role for 0.05% chlorhexidine gluconate irrigation in mitigating infection risk whether antibiotic prophylaxis timing is suboptimal or ideal.

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.

scholarly journals Effect of a single preoperative dose of oral antibiotic to reduce the incidence of surgical site infection following below-knee dermatological flap and graft repair

2019 ◽  
pp. 28-35 ◽  
Author(s):  
Helena Rosengren ◽  
Clare Heal ◽  
Petra Buettner
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Controlled Trial ◽  
Study Groups ◽  
High Dose ◽  
Antibiotic Administration ◽  
Oral Antibiotic ◽  
Site Infection ◽  
Double Blind

Background: Surgical site infection (SSI) rates for below-knee dermatological surgery are unacceptably high, particularly following complex flap and graft closures. The role of antibiotic prophylaxis for these surgical cases is uncertain. Objective: To determine whether SSI following complex dermatological closures on the leg could be reduced by antibiotic prophylaxis administered as a single oral preoperative dose. Methods: A total of 115 participants were randomized to 2 g of oral cephalexin or placebo 40-60 minutes prior to surgical incision in a prospective, randomized, double-blind, placebo-controlled trial at a primary care skin cancer clinic in North Queensland, Australia. Results: Overall 17/55 (30.9%) controls and 14/55 (25.5%) intervention participants developed infection (P = 0.525). There was no difference between the study groups in adverse symptoms that could be attributed to high-dose antibiotic administration (P = 1).

Administrative coding methods impact surgical site infection rates

2020 ◽  
Vol 41 (12) ◽  
pp. 1461-1463
Author(s):  
Mohammed A. Alsuhaibani ◽  
Mohammed A. Alzunitan ◽  
Kyle E. Jenn ◽  
Michael B. Edmond ◽  
Angelique M. Dains ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
International Classification Of Diseases ◽  
Site Infection ◽  
Coding System ◽  
Infection Rates ◽  
Coding Method ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
The Impact

AbstractWe performed a retrospective analysis of the impact of using the International Classification of Diseases, Tenth Revision procedure coding system (ICD-10) or current procedural terminology (CPT) codes to calculate surgical site infection (SSI) rates. Denominators and SSI rates vary depending on the coding method used. The coding method used may influence interhospital performance comparisons.

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.

Intrawound Low-dose Vancomycin (250 mg) Powder has Lower Risk of Wound Dehiscence than Higher Doses in Spine Surgeries

2021 ◽  
pp. 46
Author(s):  
Ahmed Sonbol
Keyword(s):  
Surgical Site Infection ◽  
Low Dose ◽  
Wound Dehiscence ◽  
High Dose ◽  
Site Infection ◽  
Systemic Complications ◽  
Significant Difference ◽  
Vancomycin Powder ◽  
Vancomycin Group ◽  
Higher Doses

Introduction: Surgical site infection post spinal surgery is a known complication which can be serious and may require aggressive intervention. Intrawound vancomycin powder application is an evolving method to prevent such complication. Although it has very low systemic complications, wound dehiscence with negative culture is reported in the literature. The aim of this study was to find the risk of wound dehiscence with low-dose intrawound vancomycin in comparison to 1 gr and its effectiveness in prevention of surgical site infection. Methodology: A chart review of all patients who underwent posterior thoracic, lumbar or sacral spine surgeries from December 2009 to September 2016 in a single center was done. Patients were categorized into three groups. First, patients who did not receive any intrawound vancomycin; second, patients who received high-dose vancomycin (1 gr); and third, patients who received low-dose vancomycin (250 mg). Additionally, patients’ demographic information, clinical data, and surgical variables were collected. Primary outcome was the presence of wound dehiscence or surgical site infection. Result: In total, 391 patients were included in this study, of which 56 (14.3%) received high-dose intrawound vancomycin, 126 (32.2%) received low dose, and 209 (53.5%) did not receive any. The overall incidence of wound dehiscence was 6.14% (24 out of 391 patients). Wound dehiscence was statistically and significantly higher (p = 0.039) in the high-dose vancomycin group in comparison to the patients who received low dose. The overall incidence of postoperative infection was 2.05% (eight patients). There was no statistically significant difference between the groups. Conclusion: The use of intrawound low-dose vancomycin (250 mg) has less wound dehiscence in comparison with other higher standard doses. Further trials are needed to evaluate the effectiveness of this dose in preventing postoperative infections.

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