Compliance with guidelines for surgical antibiotic prophylaxis: associated factors and occurrence of surgical-site infections in a pediatric population of a tertiary hospital

2018 ◽  
Vol 28 ◽  
Author(s):  
José Carlos Matos ◽  
Isabela Nascimento Borges ◽  
Maria Aparecida Martins ◽  
Elizabeth Barbosa França
Keyword(s):  
Antibiotic Prophylaxis ◽  
Associated Factors ◽  
Pediatric Population ◽  
Surgical Site Infections ◽  
Tertiary Hospital ◽  
Surgical Antibiotic Prophylaxis

scholarly journals Knowledge, attitude and practice of surgical staff towards preoperative surgical antibiotic prophylaxis at an academic tertiary hospital in Sudan

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Ali Mohammed Ahmed ◽  
Sara Nasr ◽  
Almegdad Mohamed Ahmed ◽  
Osama Elkhidir
Keyword(s):  
Antibiotic Prophylaxis ◽  
Surgical Site Infections ◽  
Tertiary Hospital ◽  
Attitude Score ◽  
Effective Measure ◽  
Strict Adherence ◽  
Attitude And Practice ◽  
Surgical Antibiotic Prophylaxis ◽  
Surgery Department ◽  
Knowledge Attitude And Practice

Abstract Background Surgical site infections (SSIs) are among the most common serious complications after surgery and associated with preventable morbidity, mortality, and increased health care costs. The use of surgical antimicrobial prophylaxis (SAP) is an effective measure that helps to protect against SSIs. This study aims to evaluate the knowledge, attitude, and practice of surgical staff towards preoperative antibiotic prophylaxis in surgery department at an academic tertiary hospital in Sudan. Methodology An observational descriptive study was conducted among doctors in the surgery department at an academic tertiary hospital in Sudan in order to assess their knowledge, attitude, and practice (KAP) towards surgical antibiotic prophylaxis (SAP). A four-section multiple-choice questionnaire was designed and hand-delivered to registered doctors in the surgery department at an academic tertiary hospital in Sudan. The WHO guidelines were used to evaluate the answers of the participants. Results Out of 56 doctors requested to participate in this study, only 49 responded and their response rate was 87.5%. Six (12.5%) surgeons had good knowledge about appropriate SAP. However, 16.3 and 24.5% of the respondents were aware of appropriate SAP in the case of Ig E-mediated reaction to penicillin and risk of Gram-negative infections, respectively. The surgeon’s attitude score about the need for local and national guidelines for SAP was 98 and 100%, respectively. Accordance of the physician’s practice with ASHP guidelines regarding timing of the first dosage of SAP was 35.4% while correct administration of an intraoperative dose was 42.9% in agreement with the guideline. 53.1% knows when to stop SAP after surgery correctly. Conclusion Although the participants in this study showed a positive attitude towards antibiotic prophylaxis guidelines, their knowledge and strict adherence to a protocolized practice per WHO checklist should be improved in order to reduce the incidence of preventable surgical site infections.

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 Appropriateness of Surgical Antibiotic Prophylaxis in a Tertiary Hospital

2014 ◽  
Vol 19 (2) ◽  
pp. 64 ◽  
Author(s):  
Eun Young Nam ◽  
Hong Bin Kim ◽  
Hyunok Bae ◽  
Soyoung Moon ◽  
Sun Hee Na ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Tertiary Hospital ◽  
Surgical Antibiotic Prophylaxis

scholarly journals 884. Evaluation of Surgical Site Infections in Solid Organ Transplant Recipients with Beta-Lactam Allergies

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S477-S478
Author(s):  
Clayton Mowrer ◽  
Trevor C Van Schooneveld ◽  
Stephen Matthews ◽  
Erica J Stohs
Keyword(s):  
Antibiotic Prophylaxis ◽  
Organ Transplant ◽  
Systemic Infection ◽  
Surgical Site Infections ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Beta Lactam ◽  
Lactam Antibiotic ◽  
Surgical Antibiotic Prophylaxis

Abstract Background Beta-lactam allergies (BLA) are common, but the prevalence and impact on solid organ transplant (SOT) recipients is largely unknown. We assessed the prevalence of BLA labels in SOT recipients at the time of transplant and evaluated their influence on surgical site infection (SSI) prophylaxis and SSI incidence. Methods All patients undergoing first heart, kidney, liver SOT at our institution were retrospectively reviewed (1/1/2015-12/31/2019). Antibiotic allergies, surgical antibiotic prophylaxis, and SSIs were abstracted from the electronic medical record. Reported BLA reactions were classified as potentially IgE-mediated, delayed, or non-allergic based on documentation. SSIs were reported according to NHSN definitions, and the incidence of SSI was compared between patients with and without reported BLA. SSI prophylaxis regimens were compared to institutional guidelines. Basic descriptive statistics were performed. Results Out of a total cohort of 751 patients (122 heart, 435 kidney, 209 liver, 4 multi-organ), 129 (17%) reported at least one BLA, with 104 (15%) with reactions to penicillins, 26 (3%) to cephalosporins, and 1 (0.1%) to carbapenems. Commonly reported reactions were rash (38%), hives (25%), and “other” (21%); 28% of documented reactions were not documented or classified as non-allergic. SSI developed in 7 (6.1%) of heart, 10 (2.5%) of kidney, and 16 (9.4%) of liver transplant recipients. Excluding 44 patients already on antibiotics for treatment of systemic infection, guideline concordant beta-lactam antibiotic surgical prophylaxis was administered to 6 (5.2%) of BLA group vs 490 (85.8%) in the non-BLA group (p&lt; 0.01); among the BLA group who did not receive a beta-lactam, 96 (83%) received a regimen concordant with institutional guidelines for penicillin allergy and 14 (12%) received guideline non-adherent regimens. Patients reporting BLA did not have a higher incidence of SSIs compared to those without BLA: 6 (4.8%) vs 27 (4.5%) respectively, p=0.86. Conclusion BLA prevalence in our SOT population was similar to previously reported rates, but many reported reactions were not allergic in nature. Pre-transplant allergy evaluation for patients with reported BLA may improve SSI antibiotic prophylaxis compliance. Disclosures All Authors: No reported disclosures

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