Audits of the quality of perioperative antibiotic prophylaxis in Shandong Province, China, 2006 to 2011

Ou, Yang; Jing, Bai-qian; Guo, Fangfang; Zhao, Liang; Xie, Qing; Fang, Yingli; Cui, Jing; Xiao, Wei; Wu, Dawei; Zhou, Wen

doi:10.1016/j.ajic.2014.01.001

Cited by 30 publications

(37 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Evidence for the effectiveness of SAP prescription is well established. Nevertheless, some studies suggest that optimal practice is not achieved in many hospitals . In this study, the practice of thoracic surgeons in Iran is fairly consistent with ASHP guidelines in terms of prescribing SAP.…”

Section: Discussionsupporting

confidence: 67%

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 67%

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

View full text Add to dashboard Cite

show abstract

“…[13] On the other hand, antibiotic choice for prophylaxis has been better (regarding appropriateness) in studies from the United States (95% of courses were appropriate),[17] Brazil (75%),[18] and China (95%). [19]…”

Section: Discussionmentioning

confidence: 99%

An audit of perioperative antimicrobial prophylaxis: Compliance with the international guidelines

2017

View full text Add to dashboard Cite

Objective:Antimicrobial prophylaxis has been demonstrated to lower the incidence of postoperative infection in nearly all types of surgery. The American Society of Health-System Pharmacists (ASHP) guideline summarizes current data on the appropriate use of antibiotic for surgical prophylaxis. The objective of this study was to assess and audit the use of antibiotics in a tertiary care center according to the recommendation of ASHP guideline.Methods:This cross-sectional study was performed using prospective data gathered from April to September 2015 in the surgical wards of Al Zahra Hospital, Isfahan, Iran. Antibiotic indication and choice, dose, dosing interval, route of administration, and timing of first administration and duration of prophylaxis were compared with the ASHP guideline recommendations.Findings:A total of 100 patients with the mean age of 49.8 ± 18.2 years were recruited for this study. About 22% of procedures had full compliance with all guideline recommendations. The most frequently encounter noncompliance type were the duration of prophylaxis (14%) and appropriate agent choice (35%). Timing of the initial dose was appropriate in most of the procedures (42%).Conclusion:This study revealed that most of the prescribed antibiotics for surgical prophylaxis are not in accordance with standard treatment guideline. The density of antimicrobial use for preoperative antimicrobial prophylaxis is very high. Furthermore, the hospital should develop a formal strategy, including a local guideline for antimicrobial prophylaxis in surgical procedures.

show abstract

“…High rates of inappropriate use of prophylactic antibiotics in surgery continue to be reported in the literature, and although evidence-based guidelines exist, poor adherence to them has been reported worldwide [27][28][29][30][31][32][33][34][35][36]. Studies reporting the impact of ASPs in surgical prophylaxis are few and often contradictory.…”

Section: Call To Action For Surgeons 627mentioning

confidence: 99%

Antimicrobial Stewardship: A Call to Action for Surgeons

Sartelli

Duane

Catena

et al. 2016

Surgical Infections

View full text Add to dashboard Cite

Despite current antimicrobial stewardship programs (ASPs) being advocated by infectious disease specialists and discussed by national and international policy makers, ASPs coverage remains limited to only certain hospitals as well as specific service lines within hospitals. The ASPs incorporate a variety of strategies to optimize antimicrobial agent use in the hospital, yet the exact set of interventions essential to ASP success remains unknown. Promotion of ASPs across clinical practice is crucial to their success to ensure standardization of antimicrobial agent use within an institution. To effectively accomplish this standardization, providers who actively engage in antimicrobial agent prescribing should participate in the establishment and support of these programs. Hence, surgeons need to play a major role in these collaborations. Surgeons must be aware that judicious antibiotic utilization is an integral part of any stewardship program and necessary to maximize clinical cure and minimize emergence of antimicrobial resistance. The battle against antibiotic resistance should be fought by all healthcare professionals. If surgeons around the world participate in this global fight and demonstrate awareness of the major problem of antimicrobial resistance, they will be pivotal leaders. If surgeons fail to actively engage and use antibiotics judiciously, they will find themselves deprived of the autonomy to treat their patients.Keywords: antibiotic prophylaxis; intra-abdominal infection; necrotizing soft tissue infection; surgical site infection; trauma A lthough most surgeons are aware of the problem of antimicrobial resistance, most underestimate this problem in their own hospital. Surgeons should always optimize antimicrobial management to maximize clinical outcome and minimize emergence of antimicrobial resistance. The necessity of formalized systematic approaches to the optimization of antibiotic therapy in the setting of surgical units worldwide, both for elective and emergency admissions, has become increasingly urgent.In 2013, a Cochrane review was published to estimate the effectiveness of professional interventions in antibiotic stewardship for hospital inpatients and to evaluate the impact of these interventions on reducing the incidence of antimicrobial resistance or Clostridium difficile infection [1]. The results showed that interventions to reduce excessive antibiotic prescribing to hospital inpatients were able to reduce antimicrobial resistance and hospitalacquired infections (HAIs), improving clinical outcome. The meta-analysis supported the use of restrictive interventions when the need is urgent, but suggested that persuasive and restrictive interventions are equally effective after six months.

show abstract

Audits of the quality of perioperative antibiotic prophylaxis in Shandong Province, China, 2006 to 2011

Cited by 30 publications

References 12 publications

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

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

An audit of perioperative antimicrobial prophylaxis: Compliance with the international guidelines

Antimicrobial Stewardship: A Call to Action for Surgeons

Contact Info

Product

Resources

About