Optimization of Delivery of Pediatric Otolaryngology Surgical Antibiotic Prophylaxis

2020 ◽  
Vol 163 (2) ◽  
pp. 275-279
Author(s):  
Pratyusha Yalamanchi ◽  
Ashley Parent ◽  
Marc Thorne
Keyword(s):  
Antibiotic Prophylaxis ◽  
Time Series Data ◽  
Prophylactic Antibiotics ◽  
Series Data ◽  
Case Mix ◽  
Antibiotic Administration ◽  
Limited Evidence ◽  
Pediatric Otolaryngology ◽  
Perioperative Antibiotics ◽  
Surgical Antibiotic Prophylaxis

Objectives There is limited evidence regarding use of routine perioperative antibiotics for pediatric otolaryngologic procedures. The objectives of this quality improvement study were (1) to characterize the otolaryngology case mix for which antibiotics were delivered and (2) determine the percentage of surgical encounters with appropriate timing of antibiotic administration. Methods Pediatric otolaryngology procedures meeting criteria from 2015 to 2019 were evaluated as a component of an institution-wide pediatric surgical antibiotic prophylaxis study using A3 problem solving to identify and roll out interventions for appropriate antibiotic administration. Descriptive statistical analysis of the interrupted time-series data was used to describe the otolaryngology case mix for which antibiotics were delivered. The primary outcome measure was percentage of surgical encounters with appropriate timing of antibiotic administration in minutes relative to incision. Results In total, 1520 pediatric otolaryngology procedures with perioperative antibiotic delivery were performed from July 2015 to September 2019. While surgical site infection number (n = 2/year) was stable, administration of timely prophylactic antibiotics significantly improved: 27.5% of cases per month at baseline and 86.9% at the conclusion of the rollout of the sequential interventions ( P < .001). Discussion Given the exceedingly low infection rate of clean otolaryngology surgery, there is limited evidence in favor of perioperative antibiotics for the majority of procedures. Prophylactic antibiotics were most commonly used in otologic surgery involving cochlear implantation or in the setting of draining ears or cholesteatoma and in clean-contaminated head and neck surgery cases. Implications for Practice Iterative continuous performance improvement can optimize evidence-based delivery of preoperative prophylactic antibiotics. Additional interventions to ensure antimicrobial stewardship in pediatric otolaryngology are indicated.

scholarly journals Antibiotic prophylaxis for surgical procedures: a scoping review

2021 ◽  
Vol 45 ◽  
pp. 1
Author(s):  
Eva Brocard ◽  
Ludovic Reveiz ◽  
Jean-Philippe Régnaux ◽  
Veronica Abdala ◽  
Pilar Ramón-Pardo ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Systematic Reviews ◽  
Scoping Review ◽  
First Generation ◽  
Evidence Base ◽  
Current Evidence ◽  
Cochrane Library ◽  
Antibiotic Administration ◽  
Significant Difference ◽  
Surgical Antibiotic Prophylaxis

Objectives. To map the current evidence on surgical antibiotic prophylaxis (SAP) administration and identify knowledge gaps in the literature available in this field. Methods. The PubMed, Cochrane Library, Epistemonikos, and Health Systems Evidence databases were searched from January 2015 to March 2020 for systematic reviews published in English, French, Portuguese, and Spanish. Results. Eighty-three systematic reviews were included, the quality of the reviews was assessed using AMSTAR 2, and data were extracted for all primary outcomes. Perioperative antibiotic administration, the use of first generation cephalosporins, and surgical site infection (SSI) were the most commonly reported for timing of antibiotic administration, drug class, and primary outcome, respectively. Findings showed that, overall, SAP may reduce SSIs compared with a placebo or with no SAP. Results suggested that intraoperative SAP may lower SSI, while postoperative SAP did not show a statistically significant difference. Conclusions. Findings have confirmed the role of SAP in reducing postoperative SSI across various surgeries and do not support the use of antibiotics after surgery to prevent infections. The findings of this scoping review have enhanced the evidence base that can inform decisions regarding the development of global guidelines for the prevention of SSI. However, high-quality systematic reviews and research reflecting diverse populations and settings are needed.

scholarly journals Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital.

2016 ◽  
Vol 43 (4) ◽  
pp. 225-234 ◽  
Author(s):  
MARISE GOUVÊA ◽  
CRISTIANE DE OLIVEIRA NOVAES ◽  
ANTONIO CARLOS IGLESIAS
Keyword(s):  
Antibiotic Prophylaxis ◽  
Prophylactic Antibiotic ◽  
University Hospital ◽  
Surgical Patients ◽  
Antibiotic Administration ◽  
Surgical Antibiotic Prophylaxis ◽  
The Right

ABSTRACT Objective : to evaluate the antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital - HUGG. Methods : we conducted a rospective study of a cohort of 256 patients undergoing elective operations between January and September 2014. We collected data on demographics, use or not of prophylactic antibiotic and the antibiotic prophylaxis following characteristics: type of antibiotic used, moment of administration and duration of postoperative use. The analyzed outcomes were "justified use or non-use of antibiotic prophylaxis", "correct antibiotic choice," "administration of the antibiotic at the right time" and "discontinuation of the antibiotic at the right time." Results : antibiotic prophylaxis was used in 91.8% of cases. The use or non-use of antibiotic prophylaxis was justified in 78.9% of patients, the choice of the administered antibiotic was considered correct in 97.9%, antibiotic administration was made at the right time in only 27.2% of patients and discontinuation of the antibiotic was performed at the correct time in 95.7% of cases. Conclusion : the surgical antibiotic prophylaxis was not fully adequately performed in the sample.

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.

Concordance Between Surgical Antibiotic Prophylaxis Practice at a University Tertiary Care Hospital and the Guideline-Based Recommendations of the Surgical Infection Society of Thailand

2021 ◽  
Vol 104 (5) ◽  
pp. 853-859
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Tertiary Care ◽  
Antibiotic Administration ◽  
Care Hospital ◽  
Site Infection ◽  
Case Record ◽  
Surgical Infection ◽  
Surgical Antibiotic Prophylaxis ◽  
Siriraj Hospital

Objective: To determine the concordance between surgical antibiotic prophylaxis (SAP) practices at Siriraj Hospital and the guideline-based recommendations for prevention of surgical site infection developed by the Surgical Infection Society of Thailand. Materials and Methods: Case record forms and medical records of 303 hospitalized patients at Siriraj Hospital who received antibiotics for prevention of surgical site infection over 24 hours on August 7, 2018 were reviewed for indication of antibiotic prophylaxis, choice of antibiotic, time of initial antibiotic administration, redosing of antibiotic, and duration of antibiotic to determine concordance with the guideline-based recommendations of the Surgical Infection Society of Thailand. Results: Two hundred twenty-one patients (mean age: 48.4 years, 62.1% female) had data suitable for inclusion in the final analysis. Cefazolin was the most commonly prescribed initial antibiotic for surgical prophylaxis. Fosfomycin, which is not listed in the guideline, was commonly used for neurosurgical prophylaxis. Regarding the concordance between SAP practice and the guideline-based recommendations, 93.8% had indications for SAP, 67.2% received the correct choice of antibiotic, 89.9% received the appropriate initial dose of antibiotic, 82.8% received antibiotic within 60 minutes before surgical incision, 26.1% received appropriate redosing in patients who required additional dose of antibiotic, 32.3% received antibiotic prophylaxis within or for 24 hours, and the proportion of patients in concordance with all guideline-based parameters was 20.9%. Two patients received antibiotic regimens that were discordant with the guidelines developed surgical site infection. Conclusion: Concordance between SAP practices at Siriraj Hospital and the guideline-based recommendations for the prevention of surgical site infection developed by the Surgical Infection Society of Thailand was found to be low with only 20.9% of study patients having met all guideline parameters. Interventions to promote, monitor, and sustain the appropriate use of SAP at Siriraj Hospital are urgently needed. Keywords: Concordance, Surgical antibiotic prophylaxis practice, SAP, Guideline-based recommendations, Surgical Infection Society of Thailand

scholarly journals Reappraisal of previously reported meta-analyses on antibiotic prophylaxis for low-risk laparoscopic cholecystectomy: an overview of systematic reviews

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e016666 ◽  
Author(s):  
Yoichi Matsui ◽  
Sohei Satoi ◽  
Satoshi Hirooka ◽  
Hisashi Kosaka ◽  
Takayuki Kawaura ◽  
...  
Keyword(s):  
Systematic Review ◽  
Laparoscopic Cholecystectomy ◽  
Antibiotic Prophylaxis ◽  
Systematic Reviews ◽  
Prophylactic Antibiotics ◽  
Low Risk ◽  
Cochrane Library ◽  
Antibiotic Administration ◽  
Postoperative Infections ◽  
Meta Analyses

IntroductionMany researchers have addressed overdosage and inappropriate use of antibiotics. Many meta-analyses have investigated antibiotic prophylaxis for low-risk laparoscopic cholecystectomy with the aim of reducing unnecessary antibiotic use. Most of these meta-analyses have concluded that prophylactic antibiotics are not required for low-risk laparoscopic cholecystectomies. This study aimed to assess the validity of this conclusion by systematically reviewing these meta-analyses.MethodsA systematic review was undertaken. Searches were limited to meta-analyses and systematic reviews. PubMed and Cochrane Library electronic databases were searched from inception until March 2016 using the following keyword combinations: ‘antibiotic prophylaxis’, ‘laparoscopic cholecystectomy’ and ‘systematic review or meta-analysis’. Two independent reviewers selected meta-analyses or systematic reviews evaluating prophylactic antibiotics for laparoscopic cholecystectomy. All of the randomised controlled trials (RCTs) analysed in these meta-analyses were also reviewed.ResultsSeven meta-analyses regarding prophylactic antibiotics for low-risk laparoscopic cholecystectomy that had examined a total of 28 RCTs were included. Review of these meta-analyses revealed 48 miscounts of the number of outcomes. Six RCTs were inappropriate for the meta-analyses; one targeted patients with acute cholecystitis, another measured inappropriate outcomes, the original source of a third was not found and the study protocols of the remaining three were not appropriate for the meta-analyses. After correcting the above miscounts and excluding the six inappropriate RCTs, pooled risk ratios (RRs) were recalculated. These showed that, contrary to what had previously been concluded, antibiotics significantly reduced the risk of postoperative infections. The rates of surgical site, distant and overall infections were all significantly reduced by antibiotic administration (RR (95% CI); 0.71 (0.51 to 0.99), 0.37 (0.19 to 0.73), 0.50 (0.34 to 0.75), respectively).ConclusionsProphylactic antibiotics reduce the incidence of postoperative infections after elective laparoscopic cholecystectomy.

scholarly journals Antibiotic prophylaxis in pre-hospital trauma care: A review of the literature

2014 ◽  
Vol 11 (5) ◽  
Author(s):  
Lynsey Smit ◽  
Malcolm Boyle
Keyword(s):  
Antibiotic Prophylaxis ◽  
Foreign Bodies ◽  
Hospital Setting ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotics ◽  
Antibiotic Administration ◽  
Search Filter ◽  
Medical Databases ◽  
Penetrating Wound ◽  
Search Terms

AbstractIntroduction Penetrating and open wounds expose an otherwise sealed and protected body to foreign bodies, leaving the patient vulnerable to potentially fatal infection. The objective of this study was to determine if the administration of systemic prophylactic antibiotics by paramedics for penetrating and/or open wounds leads to decreased infection rates and improved patient outcomes.MethodsA literature search of the electronic medical databases CINAHL, Cochrane, EMBASE and MEDLINE was conducted. The databases were reviewed from January 2000 to March 2013. A pre-hospital search filter was applied to each database with additional search terms of ‘open wound’, ‘penetrating wound’, ‘prophylactic antibiotic’. References of retrieved articles were also reviewed. Articles were included if they reported on the administration of prophylactic antibiotics by paramedics for penetrating or significant open wounds. ResultsA total of 1280 articles were identified in the search with four articles meeting the inclusion criteria. All four articles focused on the combat setting and management of soldiers with combat-related open or penetrating wounds. Two studies supported the use of prophylactic antibiotics whereas the third did not, stating that the evidence was low level and the practice of antibiotic administration was more opinion based.ConclusionThis study identified that there is scant evidence to support the use of systematic antibiotic prophylaxis in the civilian pre-hospital setting for open wounds. There is a need for further research to identify if this view may change in the future.

Graphical Exploratory Data Analysis for Categorical Longitudinal and Time Series Data

2013 ◽  
Author(s):  
Stephen J. Tueller ◽  
Richard A. Van Dorn ◽  
Georgiy Bobashev ◽  
Barry Eggleston
Keyword(s):  
Time Series ◽  
Data Analysis ◽  
Exploratory Data Analysis ◽  
Time Series Data ◽  
Series Data ◽  
Exploratory Data

Some statistical and CI models to predict chaotic high-frequency financial data

2020 ◽  
Vol 39 (5) ◽  
pp. 6419-6430
Author(s):  
Dusan Marcek
Keyword(s):  
Time Series Data ◽  
Moving Average ◽  
Methodological Approach ◽  
Back Propagation ◽  
Large Data ◽  
Series Data ◽  
Data Set ◽  
Training Time ◽  
Optimal Population ◽  
Forecast Time

To forecast time series data, two methodological frameworks of statistical and computational intelligence modelling are considered. The statistical methodological approach is based on the theory of invertible ARIMA (Auto-Regressive Integrated Moving Average) models with Maximum Likelihood (ML) estimating method. As a competitive tool to statistical forecasting models, we use the popular classic neural network (NN) of perceptron type. To train NN, the Back-Propagation (BP) algorithm and heuristics like genetic and micro-genetic algorithm (GA and MGA) are implemented on the large data set. A comparative analysis of selected learning methods is performed and evaluated. From performed experiments we find that the optimal population size will likely be 20 with the lowest training time from all NN trained by the evolutionary algorithms, while the prediction accuracy level is lesser, but still acceptable by managers.

Faktor-Faktor Yang Mempengaruhi Nilai Tukar Dollar Amerika Serikat Terhadap Rupiah Tahun 2000–2013

2017 ◽  
Vol 1 (2) ◽  
pp. 177-191
Author(s):  
Rizki Rahma Kusumadewi ◽  
Wahyu Widayat
Keyword(s):  
Time Series ◽  
Exchange Rate ◽  
Money Supply ◽  
Time Series Data ◽  
The United States ◽  
Economic Conditions ◽  
Series Data ◽  
Arch Model ◽  
United States Dollar ◽  
The Exchange Rate

Exchange rate is one tool to measure a country’s economic conditions. The growth of a stable currency value indicates that the country has a relatively good economic conditions or stable. This study has the purpose to analyze the factors that affect the exchange rate of the Indonesian Rupiah against the United States Dollar in the period of 2000-2013. The data used in this study is a secondary data which are time series data, made up of exports, imports, inflation, the BI rate, Gross Domestic Product (GDP), and the money supply (M1) in the quarter base, from first quarter on 2000 to fourth quarter on 2013. Regression model time series data used the ARCH-GARCH with ARCH model selection indicates that the variables that significantly influence the exchange rate are exports, inflation, the central bank rate and the money supply (M1). Whereas import and GDP did not give any influence.

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