Adherence of Surgeons to Antimicrobial Prophylaxis Guidelines in a Tertiary General Hospital in a Rapidly Developing Country

Abstract

Objectives. To assess the standard practice of care of surgeons regarding surgical antibiotic prophylaxis, to identify gaps, and to set recommendations. Methods. A retrospective analysis of data obtained from different surgical units in a single center in Qatar over a 3-month period in 2012. A total of 101 patients who underwent surgery and followed regimes for surgical prophylaxis as per hospital guidelines were included in the study. Results. The overall use of antibiotic was 89%, whereas the current practice did not match the recommended hospital protocols in 53.5% of cases. Prolonged antibiotics use (59.3%) was the commonest reason for nonadherence followed by the use of an alternative antibiotic to that recommended in the protocol (31.5%) and no prophylaxis was used in 9.2% of cases. The rate of compliance was significantly higher among clean surgery than clean contaminated group (P = 0.03). Forty-four percent of clean and 65% of clean-contaminated procedures showed noncompliance with the recommended surgical antimicrobial prophylaxis hospital guidelines. Conclusion. Lack of adherence to hospital protocols is not uncommon. This finding remains a challenge to encourage clinicians to follow hospital guidelines appropriately and to consistently apply the surgical antibiotic prophylaxis. The role of clinical pharmacist may facilitate this process across all surgical disciplines.

Adherence to American society of health-system pharmacists surgical antibiotic prophylaxis guidelines in a teaching hospital

“…However, the use of third generation cephalosporins and aminoglycosides are not recommended for SSI prophylaxis because of less activity against staphylococci infections compared to cefazolin, and excessive use of broad-spectrum antibiotics for prophylaxis increases the risk for resistance, causes more adverse events, and increases health care costs. [252728] Also use of vancomycin for antibiotic prophylaxis of surgery was not reported in our study. This may related to not observation of methicillin-resistant Staphylococcus aureus (MRSA) colonization or MRSA outbreaks in hospital wards.…”

Improvement in Adherence to Surgical Antimicrobial Prophylaxis Guidelines after Implementation of a Multidisciplinary Quality Improvement Project

“…6 However, despite the presence of evidence-based guidelines, poor adherence to guidelines has been reported internationally. [7][8][9][10][11][12][13] The King Hussein Cancer Centre (KHCC) in Amman, Jordan, is a 170-bed comprehensive teaching cancer centre with a surgical service consisting of nine teams with various specialties. Among these teams, an average of 25 patients are seen and five major elective surgeries are performed per day.…”

Perioperative antimicrobials: Should we be concerned about antimicrobial drug use in equine surgical patients?

“…Inappropriate prophylactic antimicrobial use is common in human hospitals with a documented detrimental impact on the patient. Patients receiving inappropriate prophylaxis had a higher nosocomial (33%) and wound infection rate (15%) compared with patients receiving appropriate prophylaxis (11% nosocomial and 5% wound infection rate) .…”