Adherence to guidelines for surgical antibiotic prophylaxis: a review

Gouvêa, Marise; Novaes, Cristiane de Oliveira; Pereira, Daniele Masterson Tavares; Iglesias, Antonio

doi:10.1016/j.bjid.2015.06.004

Cited by 67 publications

(62 citation statements)

References 23 publications

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“…In their systematic review of adherence to surgical antibiotic prophylaxis protocols, Gouvêa et al 35 concluded that all the studies reviewed indicated the need for greater adherence to such protocols. In our study, despite the outcomes "correct antibiotics choice" and "discontinuation of antibiotic at the right time" having reached rates close to 100%, the other two outcomes did not show sufficient results.…”

mentioning

confidence: 99%

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

Gouvêa

Novaes

Iglesias

2016

Rev. Col. Bras. Cir.

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Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital. Avaliação da antibioticoprofilaxia em pacientes cirúrgicos no HospitalUniversitário Gaffrée e Guinle. This complication is one of the main forms of infections related to health care in Brazil, as demonstrated in a study conducted by the Ministry of Health, which observed SSI in 11% of all surgical procedures analyzed 4 . SSI occupies the third place in frequency among all the others, accounting for about 15% of all infectious processes observed in hospitalized patients 2,5 .Moreover, this type of complication involves financial burden to the patient, to the hospital and to the healthcare system. These facts make SSI an important public health problem and therefore a target for improving the quality of care to the patient who is candidate to surgical treatment 6 .Antibiotic prophylaxis is part of a set of measures that aim to reduce SSI incidence. The main aim of antibiotic prophylaxis is to reduce the bacterial load in the wound, to assist the natural host defenses in preventing SSI Efforts have been undertaken to establish protocols to guide the appropriate use of antibiotic prophylaxis for SSI prevention, whose goal is to provide health professionals with a standardized approach to the safe, effective and rational use of antimicrobials 9 .The aim of this study was to evaluate the use of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital, in the city of Rio de Janeiro. Gouvêa Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital METHODSThis is a prospective study of a cohort composed of patients undergoing elective surgical procedures between January and September 2014. Of the 283 patients who were initially candidates to participate in the study, we excluded 27 because they do not meet the established criteria, the final sample thus comprising 256 cases.We conducted the study at the Gaffrée e Guin- The sample calculation considered the likelihood of appropriate use of antibiotic prophylaxis to 50%, with 95% confidence interval, and type I error <5%.Thus, the estimated sample of 232 patients.Data collection included three different times:preoperative time, perioperative one and up to the seventh postoperative day; we performed the record in a standardized form. In cases of administered antibiotic, we STATISTICAL ANALYSISWe performed univariate analyzes by means of simple frequencies in order to describe the study sample, and bivariate analysis to detect differences in the distribution of independent variables for each outcome of interest, using the chi-square test. We also employed multivariate logistic regression, including the indepen- RESULTSThe characteristics of the sample represented by the 256 patients studied and the analyzed outcomes are shown in Tables 1, 2 and 3. Most patients were female (64.8%). The age ranged from 19 to 90 years, with a mean age of 52.9±16.2 and with a predominance of non-elderly (62.1%).Rega...

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confidence: 99%

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

Gouvêa

Novaes

Iglesias

2016

Rev. Col. Bras. Cir.

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“…This has made the introduction of and adherence to such strategies the focus of research from a range of medical fields over recent decades (Prior, Guerin, & Grimmer-Somers, 2008;Tomasone, Chaudhary, & Brouwers, 2015). Several studies suggest that nonadherence to guidelines is widespread among health professionals (Corallo et al, 2014;Gouvêa, Novaes, Pereira, & Iglesias, 2015). Nonetheless, health professionals believe that the variability in clinical practice is not worrisome and that such variability is justified by clinical differences between patients (Arts, Voncken, Medlock, Abu-Hanna, & van Weert, 2016;Cook et al, 2018).…”

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confidence: 99%

Availability and perceived usefulness of guidelines and protocols for subcutaneous hydration in palliative care settings

Cabañero‐Martínez

Ramos‐Pichardo

Velasco-Álvarez

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To evaluate the availability of, adherence to, and perceived usefulness of guidelines and protocols for managing hydration and subcutaneous hydration in palliative care settings. Background Hydration at the end of life and the use of a subcutaneous route to hydrate generate some controversy among health professionals for different reasons. Having guidelines and protocols to assist in decision‐making and to follow a standard procedure may be relevant in clinical practice. Design Cross‐sectional telephone survey, with closed‐ended and open‐ended questions designed specifically for this study. Methods Data were obtained from 327 professionals, each from a different palliative care service. Mean, standard deviation, minimum and maximum were calculated for continuous variables; frequency distributions were obtained for categorical variables. A qualitative content analysis was performed on the open‐ended questions. The article adheres to the STROBE guidelines for reporting observational studies. Results Only 24.8% of the participants had guidelines available to assist in making decisions regarding hydration, and 55.6% claimed to follow them ‘always or almost always’. Of the participants, 38.8% had subcutaneous hydration protocols available, while 78.7% stated that they ‘always or almost always’ followed these protocols. The remaining participants considered the protocols as useful tools despite not having them available. Conclusions Only 25% of the participants' services had guidelines for hydration, and less than 40% had protocols for subcutaneous hydration. However, adherence was high, especially in cases where protocols existed. Among the participants who did not have guidelines and protocols, attitudes were mostly favourable, but mainly as a reference and support for an individualised clinical practice. Relevance to clinical practice Guidelines and protocols on hydration in palliative care may be more useful as a solid reference and support for individualised practice than as instruments for standardising care. From this perspective, their development and availability in palliative care services are recommended.

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“…Surgical site infections (SSIs) are the third most frequent cause of nosocomial infections, increasing the rates of morbidity and mortality, and the costs and length of hospitalisation. Administration of surgical antibiotic prophylaxis (SAP) could reduce the risk of SSIs and their related complications . The main goal of SAP is to reduce the burden of microorganisms at the surgical site during an operation .…”

Section: Introductionmentioning

confidence: 99%

“…Administration of surgical antibiotic prophylaxis (SAP) could reduce the risk of SSIs and their related complications. 1,2 The main goal of SAP is to reduce the burden of microorganisms at the surgical site during an operation. 3 To achieve this goal, the most common pathogens associated with the surgical procedures should be considered.…”

Section: Introductionmentioning

confidence: 99%

Adherence to American Society of Health‐System Pharmacists guidelines for antibiotic prophylaxis in thoracic surgery: a prospective observational study

Shadmehr

Baniasadi

2019

Pharmacy Practice and Res

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Background Surgical antibiotic prophylaxis (SAP) decreases the incidence of surgical site infections. However, inappropriate use of prophylactic antibiotics may lead to antibiotic resistance, prolonged hospital stay and adverse drug reactions. Aim This prospective study aimed to assess the concordance of prophylactic antibiotic administration for thoracic operations in Iran with American Society of Health‐System Pharmacists (ASHP) guidelines. Methods The appropriateness of SAP administration in 222 thoracic operations was assessed in a respiratory referral centre over a period of 4 months. Demographic, clinical and SAP data were recorded from patient files. ASHP guidelines were used to evaluate the appropriateness of prophylactic antibiotic administration. Results Cefazolin was correctly prescribed for approximately 70% of patients who required antibiotic prophylaxis. SAP was administered at the correct time (within 60 min before surgery) for 71.6% of surgeries. Intraoperative doses were correctly given in 27.7% of prolonged procedures. In 86.7% of surgeries, antibiotic administration was continued for more than 24 h after surgery (based on a physician's opinion or recent microbiological cultures). Conclusion The results suggest a relatively low rate of consistency between SAP administration and ASHP guidelines in Iran. A long duration of antibiotic administration after operations is an important finding, which should be considered and re‐evaluated by thoracic surgeons in Iran.

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Adherence to guidelines for surgical antibiotic prophylaxis: a review

Abstract: Significant variations were observed in all the outcomes assessed, and all the studies indicated a need for greater adherence to guidelines for surgical antibiotic prophylaxis.

Cited by 67 publications

References 23 publications

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

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

Availability and perceived usefulness of guidelines and protocols for subcutaneous hydration in palliative care settings

Adherence to American Society of Health‐System Pharmacists guidelines for antibiotic prophylaxis in thoracic surgery: a prospective observational study

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