Assessment of implementation of antibiotic stewardship program in surgical prophylaxis at a secondary care hospital in Ras Al Khaimah, United Arab Emirates

Abstract

Antibiotic overuse is a major factor for causing antibiotic resistance globally. However, only few studies reported the implementation and evaluation of antimicrobial stewardship programs in Gulf Cooperation Council. This study was conducted within 8-months periods to evaluate the effect of the newly implemented antibiotic stewardship program on improving the prescribing practice of surgical antibiotic prophylaxis in a secondary care hospital in the United Arab Emirates by releasing local hospital guidelines. The data of 493 in patients were documented in the predesigned patient profile form and the prescribing practice of surgical antibiotic prophylaxis for clean and clean-contaminant surgical procedures was compared and analyzed two months’ prior (period A) and post (period B) the implementation of antibiotic stewardship program. The 347 patient’s data (PD) were analyzed during period A and 146 PD during period B. The prescription of piperacillin/tazobactam was decreased from 2.4% from all surgical prophylaxis antibiotic orders in period A to 0% in period B. The appropriateness of the antibiotic therapy was found to differ non significantly for the selection of prophylactic antibiotic (p = 0.552) and for the timing of first dose administration (p = 0.061) between A and B periods. The total compliance was decreased non significantly (P = 0.08) from 45.3 to 40.2%. Overall, the guidelines have improved the prescribing practice of antibiotics prior to surgery. However, further improvement can be achieved by initiating educational intervention via cyclic auditing strategy.

Appropriateness and adherence to guidelines in perioperative antimicrobial prophylaxis in patients undergoing clean surgery: results from a Quality Control Circle intervention

“…were prescribed, as they are associated with increased emerge of extendedspectrum β-lactamases and Clostridioides di cile strians. The selection of appropriate antimicrobial agents in the present study pre QCC intervention (78.82%) was higher to that of a recent study (55.3%) [19], but lower to that reported by Pittalis et al (84.5%) [20]. While after the QCC intervention almost 96% received the appropriate antimicrobial agents for their surgical procedure.…”

Sustained Improvement of Appropriateness in Surgical Antimicrobial Prophylaxis with the Application of Quality Control Circle

“…One of the most crucial issues for appropriate SAP depending on possible contaminating bacteria and their susceptibility to antimicrobial, whether antimicrobial can reach an effective concentration at the surgical site. 19 In accordance with the international and native guidelines, first-or second-generation cephalosporin was appropriately selected and administered than other classes of antimicrobial, cefazolin and cefuroxime were the first antimicrobial of choice for majority of the surgical procedures, according to the guidelines composed by China Ministry of Health. In our study, although the most frequently prescribed antimicrobial were cefazolin and cefuroxime, antimicrobial selection was found to be inappropriate in 21.18% of cases before QCC intervention.…”

Tình Hình Sử Dụng Kháng Sinh Dự Phòng Trên Bệnh Nhân Phẫu Thuật Mổ Lấy Thai Tại Một Bệnh Viện Tỉnh Sóc Trăng Năm 2022

“…Tuy nhiên, một số nghiên cứu thực hiện gần đây ở Việt Nam cho thấy việc thực hành sử dụng kháng sinh dự phòng còn nhiều hạn chế như: lựa chọn kháng sinh chưa hợp lý, liều dùng kháng sinh chưa hợp lý [5], [6]. Việc sử dụng kháng sinh không hợp lý trong phẫu thuật có thể đưa đến việc tăng nguy cơ gặp tác dụng phụ, tăng độc tính, tăng nguy cơ đề kháng kháng sinh, tăng thời gian nằm viện và chi phí điều trị [7], [8]. Tại tỉnh Sóc Trăng chưa có nghiên cứu đánh giá tính hợp lý trong sử dụng kháng sinh trên bệnh nhân phẫu thuật mổ lấy thai.…”