Utilization of neurosurgical perioperative antimicrobial prophylaxis in a Chinese teaching hospital

2021 ◽  
Author(s):  
Weiwei Zhang ◽  
Huijie Meng ◽  
Chientai Mao ◽  
Yongfang Hu
Keyword(s):  
Teaching Hospital ◽  
Antimicrobial Prophylaxis ◽  
Chinese Teaching ◽  
Perioperative Antimicrobial Prophylaxis

scholarly journals Implementation and Evaluation of a Preprinted Perioperative Antimicrobial Prophylaxis Order Form in a Teaching Hospital

1998 ◽  
Vol 9 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Paul Au ◽  
Suzette Salama ◽  
Coleman Rotstein
Keyword(s):  
Teaching Hospital ◽  
Surgical Procedures ◽  
Antimicrobial Prophylaxis ◽  
Drug Acquisition ◽  
Trial Period ◽  
Surgical Prophylaxis ◽  
Improvement Project ◽  
Order Form ◽  
Acquisition Costs ◽  
Perioperative Antimicrobial Prophylaxis

OBJECTIVE: To determine the effect of a preprinted perioperative antimicrobial prophylaxis order form on the appropriateness, standardization and cost of surgical prophylaxis.DESIGN: A pre- and postintervention prospective study with evaluation of drug acquisition costs in selected surgical procedures.SETTING: A 420-bed teaching hospital in the Hamilton-Wentworth region.PATIENTS: A three-month survey of 901 consecutive patients followed by a two-month trial period of 725 consecutive patients undergoing general surgery, orthopedic and urological procedures.INTERVENTION: A perioperative antimicrobial prophylaxis order form was developed based on guidelines from the literature and input from physician and nursing staff. The form was introduced through educational inservices and put into operation.MEASUREMENT: The measurement of antimicrobial perioperative prophylaxis appropriateness and drug acquisition costs were assessed pre- and postintroduction of the order form. Subsequently, prescriber compliance and satisfaction with the program were also evaluated.RESULTS: Appropriateness of perioperative antimicrobial surgical prophylaxis was increased from 36% in the baseline period to 79% in the trial period (P<0.0001). A reduction of $440.71 ($23.20/procedure) in drug acquisition costs was observed for 19 matched hip and knee prosthetic surgical procedures between the baseline and trial periods. In addition, compliance with the perioperative order form rose steadily during the trial period. Physician prescribers reported that the form was used, and was appropriate and user-friendly but that it did not influence their prescribing habits. Nurses responded that the form was helpful and improved the timing of prophylaxis.CONCLUSIONS: The perioperative antimicrobial prophylaxis order form standardized antimicrobial administration time and resulted in an increase in appropriateness. A reduction in antimicrobial costs for surgical procedures was realized. This quality improvement project has enhanced the quality of patient care.

scholarly journals Characterization of carbapenem-resistant Acinetobacter baumannii isolates in a Chinese teaching hospital

2015 ◽  
Vol 6 ◽  
Author(s):  
Yaowen Chang ◽  
Guangxin Luan ◽  
Ying Xu ◽  
Yanhong Wang ◽  
Min Shen ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Teaching Hospital ◽  
Carbapenem Resistant ◽  
Chinese Teaching

First description of NDM-1-, KPC-2-, VIM-2- and IMP-4-producing Klebsiella pneumoniae strains in a single Chinese teaching hospital

2014 ◽  
Vol 143 (2) ◽  
pp. 376-384 ◽  
Author(s):  
Y. LIU ◽  
L.-G. WAN ◽  
Q. DENG ◽  
X.-W. CAO ◽  
Y. YU ◽  
...  
Keyword(s):  
16S Rrna ◽  
Klebsiella Pneumoniae ◽  
Teaching Hospital ◽  
Multidrug Resistant ◽  
The Other ◽  
Quinolone Resistance ◽  
Resistance Determinants ◽  
Carbapenem Resistant ◽  
Extended Spectrum ◽  
Chinese Teaching

SUMMARYA total of 180 non-duplicate carbapenem-resistant Klebsiella pneumoniae isolates were recovered from patients hospitalized between December 2010 and January 2012 at a Chinese hospital. Eight KPC-2, four NDM-1, one VIM-2, and five KPC-2 plus IMP-4 producers were identified and all were multidrug resistant due to the presence of other resistance determinants, including extended-spectrum β-lactamases (CTX-M-15, SHV-12), 16S rRNA methylases (armA, rmtB) and plasmid-mediated quinolone-resistance determinants (qnrA, B, S, aac(6′)-Ib-cr). Nine K. pneumoniae clones (Kpn-A1/ST395, Kpn-A3/ST11, Kpn-A2/ST134, Kpn-B/ST263, Kpn-C/ST37, Kpn-D/ST39, Kpn-E/ST1151, Kpn-F/ST890, Kpn-G/ST1153) were identified. blaKPC-2 was located on transferable ~65 kb IncL/M (ST395, ST11, ST134, ST39) and ~100 kb IncA/C (ST37, ST1153, ST890) plasmids, respectively. On the other hand, blaNDM-1 was associated with a ~70 kb IncA/C plasmid (ST263). However, non-typable plasmids of ~40 kb containing blaVIM-2 were detected in the ST1151 clone. This work reports the first co-occurrence of four diverse types of carbapenemase of K. pneumoniae clones from a single hospital in China. IncA/C, IncL/M, and other successful plasmids may be important for the dissemination of carbapenemases, producing a complex epidemiological picture.

Antimicrobial prophylaxis for adult surgical patients in a Pakistani teaching hospital

2020 ◽  
Vol 55 (2) ◽  
pp. 143-149
Author(s):  
Z. Khan ◽  
N. Ahmed ◽  
S. Zafar ◽  
A.U. Rehman ◽  
F.U. Khan ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Antimicrobial Prophylaxis ◽  
Surgical Patients

scholarly journals PRESCRIPTION PATTERN OF PROPHYLACTIC ANTIMICROBIAL AGENTS USED IN PREOPERATIVE PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL

2018 ◽  
Vol 10 (4) ◽  
pp. 128
Author(s):  
Kala P. ◽  
Jamuna Rani R. ◽  
Sangeetha Raja
Keyword(s):  
Teaching Hospital ◽  
Antimicrobial Agents ◽  
Antimicrobial Prophylaxis ◽  
Tertiary Care ◽  
Antibiotic Policy ◽  
Prescription Pattern ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Institutional Ethics ◽  
Cefoperazone Sodium

Objective: This study was designed to analyze the prescription pattern of prophylactic antimicrobial agents used in preoperative patients.Methods: A descriptive observational study was done at a tertiary care teaching hospital in Potheri from July to December 2013 after obtaining of Institutional Ethics Committee clearance.Results: Total 284 patients were included in this study, out of which 141(49.6%) were females and 143(50%) were males. In the department of general surgery, the very commonly used antimicrobial agents were cefotaxime (81%) followed by cefoperazone sodium (42%). In the orthopaedics department, the frequently used antimicrobial agents were cefoperazone and sulbactam (39%) followed by cefazolin (29%). Most commonly used antimicrobial agent was cefotaxime (100%) in gynaecology department.Conclusion: Antimicrobial prophylaxis is helpful in declining the frequency of post-operative infections. This study explained about the various antimicrobial agents used prior to surgeries. Practitioners must prescribe an antibiotic based on their hospital antibiotic policy.

Perioperative antimicrobial prophylaxis in adult patients: The first multicenter clinical practice audit with intervention in Greek surgical departments

2020 ◽  
pp. 1-8
Author(s):  
Elisavet Chorafa ◽  
Elias Iosifidis ◽  
Sotirios Tsiodras ◽  
Athanasios Skoutelis ◽  
Eleni Kourkouni ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Antimicrobial Agents ◽  
Antimicrobial Prophylaxis ◽  
Surgical Site Infections ◽  
Audit And Feedback ◽  
Elective Surgical Procedures ◽  
Before And After ◽  
Greek Hospitals ◽  
Practice Audit ◽  
Perioperative Antimicrobial Prophylaxis

Abstract Objective: To audit clinical practice and implement an intervention to promote appropriate use of perioperative antimicrobial prophylaxis (PAP). Design: Prospective multicenter before-and-after study. Setting: This study was conducted in 7 surgical departments of 3 major Greek hospitals. Methods: Active PAP surveillance in adults undergoing elective surgical procedures was performed before and after implementation of a multimodal intervention. The surveillance monitored use of appropriate antimicrobial agent according to international and local guidelines, appropriate timing and duration of PAP, overall compliance with all 3 parameters and the occurrence of surgical site infections (SSIs). The intervention included education, audit, and feedback. Results: Overall, 1,447 patients were included: 768 before and 679 after intervention. Overall compliance increased from 28.2% to 43.9% (P = .001). Use of antimicrobial agents compliant to international guidelines increased from 89.6% to 96.3% (P = .001). In 4 of 7 departments, compliance with appropriate timing was already >90%; an increase from 44.3% to 73% (P = .001) and from 20.4% to 60% (P = .001), respectively, was achieved in 2 other departments, whereas a decrease from 64.1% to 10.9% (P = .001) was observed in 1 department. All but one department achieved a shorter PAP duration, and most achieved duration of ~2 days. SSIs significantly decreased from 6.9% to 4% (P = .026). After the intervention, it was 2.3 times more likely for appropriate antimicrobial use, 14.7 times more likely to administer an antimicrobial for the appropriate duration and 5.3 times more likely to administer an overall appropriate PAP. Conclusion: An intervention based on education, audit, and feedback can significantly contribute to improvement of appropriate PAP administration; further improvement in duration is needed.

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