scholarly journals The Use of Prophylactic Antibiotics on Orthopaedic Procedures in an Academic Hospital in Indonesia

2021 ◽  
Vol 2 (2) ◽  
pp. 88-94
Author(s):  
Yuani Setiawati ◽  
Azmi Farhadi
Keyword(s):  
Orthopaedic Surgery ◽  
Compliance Rate ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Control Program ◽  
Prophylactic Antibiotics ◽  
Orthopedic Procedures ◽  
Delivery Mode ◽  
Using Data ◽  
Clean Contaminated

Background: Surgical site infections (SSIs) are common surgical complications that will increase cost of treatment. The incidence of SSI can be prevented with antibiotic prophylactic. Uncompliance using of prophylactic antibiotics is one of the factors leading to the occurrence a microbes resistance. The data on the using of prophylactic antibiotics in Indonesia is still limited. Objective: This study aims to analyze the using of prophylactic antibiotic guideline on orthopaedic surgery. Methods: The study was conducted retrospectively using data from medical records on patients who had clean and clean-contaminated orthopedic procedures from 2013 to 2016 in the standard operating room of Dr. Soetomo hospital Surabaya. We analyzed the use of prophylactic antibiotics in terms of antibiotic selection, timing of administration, and the compliance to the prophylactic antibiotic local guidelines on orthopaedic surgery. Results: Overall, patient data from 2013 to 2016 was 5246 patients. The compliance rate of prophylactic antibiotics from 2013 to 2016 was 48.3%. This level of compliance uses a selection of antibiotics, dose of administration, delivery mode, delivery time, and route of administration. Conclusion: The results of this study have shown that the prophylactic antibiotic compliance rate on orthophaedic procedures in Soetomo Hospital from 2013 to 2016 was 48,3%. Antibiotic resistance control program quite effective at increasing compliance with the use of the prophylaxis antibiotics.

scholarly journals A new antibiotic stewardship program approach is effective on inappropriate surgical prophylaxis and discharge prescription

2019 ◽  
Vol 13 (11) ◽  
pp. 961-967 ◽  
Author(s):  
Cem Karaali ◽  
Mustafa Emiroglu ◽  
Sabri Atalay ◽  
Ismail Sert ◽  
Ayberk Dursun ◽  
...  
Keyword(s):  
Antibiotic Prescription ◽  
Statistical Significance ◽  
Compliance Rate ◽  
Prophylactic Antibiotic ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Stewardship Program ◽  
Surgical Antibiotic Prophylaxis ◽  
Clean Contaminated

Introduction: This study aims to evaluate the efficacy of a new antimicrobial stewardship program (ASP) on surgical antibiotic prophylaxis (SP) and antibiotics in discharge prescriptions used as a continuation of SP. Methodology: The study included elective patients with clean and clean-contaminated wounds. The accuracy of the assigned SP was evaluated according to international guidelines. Primary outcome measures comprised appropriateness of prophylactic antibiotic indication, correct timing of initial dose, discontinuation of SP within 24 hours, and antibiotic prescription at discharge. A secondary outcome measure was to determine whether the effect of ASP was sustained long-term. Results: The total compliance rate for all stages of SP increased from 8% to 52.1% after the intervention (p < 0.05). When analyzed according to individual SP components, it was found that although ASP did not change first dose timing rates, it did affect the rates of prophylactic antibiotic indication, discontinuation of SP within 24 hours and antibiotic prescription at discharge, with statistical significance (p < 0.05). In addition, ASP continued to increase its effectiveness throughout the 3rd year. Conclusions: Based on the findings of our study, it seems clear that the modified ASP introduced in our general surgery clinic can be used effectively and simply; in addition, this ASP increases its efficacy with time.

scholarly journals Perioperative antimicrobial prophylaxis in patients receiving antibiotic therapy

2021 ◽  
Author(s):  
Yiwei Yin ◽  
Eljim P Tesoro ◽  
Alan E Gross ◽  
Jeffery J Mucksavage
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Antimicrobial Prophylaxis ◽  
Prophylactic Antibiotic ◽  
Kidney Injury ◽  
Retrospective Chart Review ◽  
Surgical Site Infections ◽  
Dose Interval ◽  
Prophylactic Antibiotics ◽  
Antibiotic Administration

Objective: Antimicrobial prophylaxis is administered perioperatively to prevent surgical site infections. However, in patients who have already received antibiotics for the treatment of active infections prior to surgery, the risks and benefits of administering prophylactic antibiotics are unknown. We aimed to assess the necessity of perioperative prophylactic antibiotic administration in patients receiving antibiotic treatment for active infections. Method: This was a retrospective, chart-review cohort study. Between January 2018 to May 2018, adult patients who underwent inpatient surgery at the University of Illinois Hospital and Health Sciences System, and were prescribed prophylactic antibiotics based on institutional protocol, while receiving antibiotic treatment within 48 hours prior to surgery, were included in the study. The primary endpoint was the rate of duplicative antibiotic therapy, which was defined as the administered prophylactic antibiotic (1) exhibiting similar or narrower bacterial coverage as the treatment antibiotic(s), and (2) given within the dose interval of the treatment antibiotic(s). Results: A total of 158 patients were included in the study, of which 70 (44.3%) received duplicative antibiotic therapy, whereas 88 (55.7%) did not. Differences in the incidence of acute kidney injury, C. difficile infection, and surgery site infections were not statistically significant between the two groups. Conclusion We found that it was common for patients receiving therapeutic systematic antibiotics to perioperatively be prescribed additional prophylactic antibiotics at our institution. However, additional prophylactic antibiotics can be unnecessary in decreasing the incidence of surgical site infections.

scholarly journals THE EFFECT OF PERIOPERATIVE AND PROPHYLACTIC ANTIBIOTICS AGAINST THE INCIDENCE OF UTI AND SURGICAL SITE INFECTIONS AFTER HYPOSPADIAS SURGERY

2017 ◽  
Vol 24 (1) ◽  
Author(s):  
Raditya Kusuma ◽  
Johan Renaldo ◽  
Tarmono Djojodimedjo ◽  
Sunaryo Hardjowijoto
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Prophylactic Antibiotics ◽  
Repair Operation ◽  
Significant Difference ◽  
Perioperative Antibiotics ◽  
Tract Infections ◽  
Hypospadias Surgery

Objective: The aim of this study is to analyze the effect of perioperative and prophylactic antibiotics against the incidence of urinary tract infections (UTI) and surgical site infections (SSI) after hypospadias surgery (hypospadias repair operation). Materials & Methods: This study is an observational study of explanation with 24 hypospadias patients (2 groups) during the period of October 2015 to February 2016. Samples were divided into two groups, 12 patients received prophylactic antibiotics and 12 patients received perioperative antibiotics (random sampling). Inclusion criteria included patients with glandular hypospadias to proximal penile hypospadias, aged 6 months until 15 years and underwent hypospadias surgery with one surgical technique namely Tubularized Incised Plate (TIP). The examination of urine culture and evaluation of the wounds were performed on day 4, 10, and 20 day after surgery to determine the incidence of urinary tract infections and surgical site infections. Results: There is no significant difference in the incidence of UTI on on day 4, 10 and 20  in perioperative group and prophylaxis group with p=0.282 and p=0.500 at day 4 and 10  (p>0.05). There is no significant difference in the incidence of SSI on day 4, 10 and 20 in the group of perioperative antibiotic and prophylactic antibiotic with p=0.680 and p=0.217 at day 4 and 10 (p>0.05). Conclusion: There is no effect of the prophylactic antibiotic as well as perioperative antibiotic treatment on the incidence of UTI and SSI

Analysis of the use of antibiotics profile and factors of surgical site infections study on digestive and oncology surgeries

2021 ◽  
Vol 32 (4) ◽  
pp. 693-700
Author(s):  
Lisa Narulita ◽  
Suharjono ◽  
Kuntaman ◽  
Mohammad Akram
Keyword(s):  
White Blood Cells ◽  
Surgical Site Infections ◽  
Prophylactic Antibiotics ◽  
Personal Hygiene ◽  
Risk Of Infection ◽  
Surgical Wound ◽  
Chi Square ◽  
Normal Ranges ◽  
Ethical Approval ◽  
Clean Contaminated

Abstract Objectives The incision method operation with a high risk of infection in a clean and clean-contaminated operation requires the use of prophylactic antibiotics to minimize the risk of infection. This study was designed to analyze the effectiveness of prophylactic antibiotics in patients with digestive and oncology surgeries. Methods The statistical method used was chi-square to determine the risk factors for infection at surgical site infections (SSI) in patients with digestive and oncology surgeries. This study had received ethical approval from the Ethics Committee of Dr. H. Slamet Martodirdjo Hospital, Pamekasan. Results There were 67 patients consisted of 48 digestive surgeries (71.6%) and 19 oncology surgeries (28.4%). The criteria of observation on day 30 showed that as 1 (1.5%) SSI patient experienced purulence, inflammation, and erythema around the surgical wound so an analysis of p>0.05 was carried out so that there was no association with the incidence of SSI during hospitalization, but other factors originating from the patient, such as a lack of personal hygiene at home and lack of nutritious food intake was measured in temperature, pulse, respiration, and white blood cells examination before surgery and 24 h after surgery, all within normal ranges. The qualitative analysis of prophylactic antibiotics using the Gyssen method showed that 31 (46.3%) rationales needed an improvement process. Conclusions The widely used prophylactic antibiotics, namely cefazolin and cefuroxime are recommended antibiotics used in incision surgery and rationale used.

scholarly journals Pengaruh Program Pengendalian Resistensi Antimikroba terhadap Penggunaan Antibiotik Profilaksis pada Bedah Obstetri dan Ginekologi

2020 ◽  
Vol 10 (2) ◽  
pp. 145
Author(s):  
Winarni Winarni ◽  
Nanang Munif Yasin ◽  
Tri Murti Andayani
Keyword(s):  
Incidence Rate ◽  
Clinical Outcomes ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Total Sample ◽  
Prophylactic Antibiotics ◽  
Control Group ◽  
Stewardship Program ◽  
The Relationship

The incidence of surgical site infections (SSI) in obstetric and gynecological surgery is quite high. Rational prophylactic antibiotics in surgery are important strategies for the prevention of SSI. Antimicrobial Stewardship Program (ASP) for rational prophylactic antibiotic use has been carried out. This study aims to determine the rationality of the use of prophylactic antibiotics and incidence rate of SSI, the effect of ASP on the rationality of prophylactic antibiotics and clinical outcomes in obstetric and gynecology surgery. This study used a quasi-experimental pretest postest design without control group with retrospective data collection. Research time for 2 months from May to June 2019. The subjects of this study were obstetric and gynecology surgery patients at Pandan Arang Hospital Boyolali in 2018 who were divided into 2 groups: patients before the ASP and patients after the ASP with a total sample of 93 patients each group. An evaluation of the type, dose, time of administration, route of administration, and duration of prophylactic antibiotics were performed against the standard. Data analysis used the Pearson Chi-square test to see the relationship between rationality and clinical outcomes with ASP. The rationality of prophylactic antibiotic use increased from 0 (0%) cases before the ASP to 52 cases (55.9%) after the ASP. The SSI incidence rate before ASP was 9.7%, down to 4.3% after ASP. There was a significant relationship between the rationality of prophylactic antibiotics and ASP (p <0.05) but the relationship between clinical outcome (SSI incidence) and ASP was not significant (p> 0.05). The result of this study can be used to promote the implementation of ASP in other wards to increase rational use of antibiotics.

A review of post-operative infections in veterinary orthopaedic surgery

2008 ◽  
Vol 21 (02) ◽  
pp. 99-105 ◽  
Author(s):  
J. S. Weese
Keyword(s):  
Infection Control ◽  
Orthopaedic Surgery ◽  
Patient Management ◽  
Surgical Site Infections ◽  
Control Program ◽  
Level Of Care ◽  
Site Infection ◽  
Infection Control Program ◽  
Inherent Risk ◽  
Infection Surveillance

SummarySurgical site infections are an inherent risk in orthopaedic surgery and many of the infections that develop are likely to be non-preventable. However, a variety of measures can be undertaken to reduce the risk and impact of surgical site infections. The development and implementation of an infection control program, including surgical site infection surveillance, can be an important tool for patient management. All veterinary practices should have some form of infection control program in order to address surgical site infections, among other issues, and to provide the optimal and expected level of care.

scholarly journals The role of prophylactic antibiotics in compound facial fractures treated by closed and open reduction

2019 ◽  
Vol 31 (3) ◽  
pp. 17-23
Author(s):  
Thamir Y. Hammadi ◽  
Thair Abdul Lateef
Keyword(s):  
Open Reduction ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotics ◽  
Current Evidence ◽  
Facial Fractures ◽  
Eligibility Criteria ◽  
Closed Treatment ◽  
Group B ◽  
Clean Contaminated

Background: The role of prophylactic antibiotics remains controversial. It is clear that actively facial fractures are considered as clean contaminated and should be treated with therapeutic antibiotics; however, there is widespread variability in the use, type, timing, and duration of prophylactic antibiotic administrated in practice today. There is an adverse effect of increased antibiotic resistance, as well as costs, it is important to review the current evidence for the role of prophylactic antibiotics in compound facial fractures. The purpose of this study is to evaluate the role and significance of preoperative, perioperative and postoperative antibiotic prophylaxis for patients when there is already an infective focus, such as compound facial fracture. Materials and methods: A total of 70 Iraqi patients aged 4-65 years, 50 males and 20 females who met the eligibility criteria were enrolled in this study to evaluate the infection rate in patients who have sustained compound facial fractures treated by open or closed treatment. The patients were divided into two groups, Group A included 50 patients who received pre, peri and post-operative antibiotics. Postoperatively the antibiotics utilized in two different regimen timing. In Group B antibiotics were administrated peri and post-operatively for 20 patients. They were then followed up to 4 weeks for any sign or evidence of infection such as pus discharge. Results: There was no significant association (p=0.664) between the incidence of post-operative infections and pre-operative administration of antibiotics. Significant association p.Value (0.032) between prevalence of postoperative infection and type of surgery. Conclusion: Perioperative prophylactic antibiotics have been proven to lower infection rates postoperatively. Open reduction presented with significant complication (infection) than closed reduction modality of treatment.

scholarly journals Single dose antibiotic prophylaxis for prevention of surgical site infection in elective surgery

2017 ◽  
Vol 5 (1) ◽  
pp. 27 ◽  
Author(s):  
Swaroop V. Borade ◽  
Obaid Syed
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Elective Surgery ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Relevant Information ◽  
Site Infection ◽  
Intraoperative Management ◽  
Clean Contaminated ◽  
A Prospective Study

Background: Surgical site infections are associated with prolonged hospital stays and increased costs. Infection develops when endogenous flora is translocated to a normally sterile site. Seeding of the operative site from a distant site of infection can also occur (especially in patients with prosthesis or another implant). Factors influencing the development of surgical site infections include bacterial inoculums and virulence, host defences, preoperative care and intraoperative management. Hence there is the need for antibiotic prophylaxis to overcome this problem. This study was planned to evaluate the effect of prophylactic antibiotic in clean and clean contaminated cases and to assess the outcome.Methods: A prospective study was conducted which include 100 patients undergoing elective surgery admitted to the department of general surgery IIMSR’s Medical College and Hospital, Warudi, Jalna, relevant information of each patient was collected according to the Performa designed for the study. Cefuroxime was used preoperatively 30 min prior to incision and its impact on postoperative wound infection was studied.Results: We had 100 cases in our study predominantly males with maximum individuals in 31-40 years age group, we had 67% clean and 33% clean contaminated surgeries done and had 3% case of superficial surgical site infection.Conclusions: A single preoperative dose of antibiotic Cefuroxime is effective to prevent surgical site infection in elective case assuming an uncomplicated procedure.

scholarly journals The Impact of Timing, Selection, and Dosage of Preoperative Prophylactic Antibiotics on Preventable Surgical Site Infections

2012 ◽  
Author(s):  
Cathy Insana
Keyword(s):  
Knee Arthroplasty ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Tissue Perfusion ◽  
Prophylactic Antibiotics ◽  
Hospital Charges ◽  
Antibiotic Administration ◽  
Surgical Incision ◽  
Total Hip ◽  
The Impact

<p>Surgical site infections (SSIs) are a subset of a larger group of infections that are known as hospital acquired infections (HAis). SSIs are a huge financial burden, costing billions of dollars in excess hospital charges every year. There is a considerable amount of evidence-based practice recommendations that can help reduce the incidence of SSIs. Research has supported the efficacy of preoperative antibiotic prophylaxis when appropriately selected and timed according to published guidelines. In addition to these measures, re-dosing of antibiotics must occur for those procedures that last more than four hours in order to continue to maintain tissue perfusion throughout the surgical procedure. The purpose of this study was to evaluate the timely administration, appropriate selection, and dosage of preoperative prophylactic antibiotics in surgical patients in one community hospital. A retrospective research design was used to obtain information on 100 randomly selected colon, hysterectomy, total hip and knee arthroplasty cases. Data were collected on those surgical procedures that occurred between October 1, 2010 and March 31 , 2011. During this time period, there were eight documented SSIs, three involving an organ space, and five that were superficial. In more than half of the colon and hysterectomy cases, the prophylactic antibiotic was administered less than 30 minutes before surgical incision, and in more than half of the total hip and total knee arthroplasty cases, antibiotic administration was between 30-60 minutes. All the procedures met the SCIP recommendations for timing and selection of prophylactic antibiotic. This study suggests that to ensure adequate tissue perfusion prior to surgical incision, the antibiotic should be administered in the preoperative holding unit, immediately prior to transfer to the operating room. This would assure that the antibiotic is given 30-60 minute timeframe, thus reducing the potential for the development of a SSI. Recommendations for further research and advanced nursing practice are discussed.</p>

scholarly journals Surgical site infection following cesarean section in a general hospital in Kuwait: trends and risk factors

2019 ◽  
Vol 147 ◽  
Author(s):  
W. Alfouzan ◽  
M. Al Fadhli ◽  
N. Abdo ◽  
W. Alali ◽  
R. Dhar
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Prophylactic Antibiotics ◽  
Drug Resistant ◽  
Surgical Morbidity ◽  
Antibiotic Policy ◽  
Infection Surveillance ◽  
A Prospective Study

Abstract Surgical site infections (SSI) are a significant cause of post-surgical morbidity and mortality. The objectives of this study were to determine the prevalence of SSI and identify risk factors for infections following cesarean section (CS). A prospective study of SSI after CS was carried out from January 2014 to December 2016 using the methodology of the American National Nosocomial Infection Surveillance System. Suspected SSIs were confirmed clinically by the surgeon, and or, by culture. Seven thousand two hundred thirty five CS were performed with an overall SSI prevalence of 2.1%, increasing from 1.7% in 2014 to 2.95% in 2016 (P = 0.010). Of 152 cases of SSI, the prevalence of infection was 46.7% in women ⩽30 years and 53.3% in women >30 years (P = 0.119). Of 148 culture samples from as many women, 112 (75.7%) yielded growth of microorganisms with 42 (37.5%) of isolates being multi-drug resistant (MDR). Women who did not receive prophylactic antibiotics (35.5%) developed SSI more often than those who did (P < 0.0001). These findings suggest that emergency CS and inappropriate antibiotic prophylaxis are risk factors for developing SSI. In the light of the emergence of MDR bacteria there is a need to implement revised prophylactic antibiotic policy as part of antimicrobial stewardship to decrease SSI rates.

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