Factors that influence adherence to surgical antimicrobial prophylaxis (SAP) guidelines: a systematic review

Hassan, Sarah; Chan, Vincent; Stevens, Julie E.

doi:10.1186/s13643-021-01577-w

Cited by 28 publications

(28 citation statements)

References 101 publications

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“…Others have also reported that physicians may prescribe antibiotics due to fear of infection-related complications [ 57 , 59 ]. Fear of repercussions could drive overuse while prescribing antibiotics provides comfort and alleviates perceived risk [ 61 ]. Finally, a related review of factors influencing adherence to guidelines on surgical antibiotic prophylaxis identified that provider training, personal experience and supervisors’ opinions may be stronger influencers on behaviour than clinical guidelines themselves [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Factors affecting the use of antibiotics and antiseptics to prevent maternal infection at birth: A global mixed-methods systematic review

et al. 2022

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Background Over 10% of maternal deaths annually are due to sepsis. Prophylactic antibiotics and antiseptic agents are critical interventions to prevent maternal peripartum infections. We conducted a mixed-method systematic review to better understand factors affecting the use of prophylactic antibiotics and antiseptic agents to prevent peripartum infections. Methods We searched MEDLINE, EMBASE, Emcare, CINAHL, Global Health, Global Index Medicus, and Maternity and Infant Care for studies published between 1 January 1990 and 27 May 2022. We included primary qualitative, quantitative, and mixed-methods studies that focused on women, families, and healthcare providers’ perceptions and experiences of prophylactic antibiotic and antiseptics during labour and birth in health facilities. There were no language restrictions. We used a thematic synthesis approach for qualitative evidence and GRADE-CERQual approach for assessing confidence in these review findings. Quantitative study results were mapped to the qualitative findings and reported narratively. Results We included 19 studies (5 qualitative, 12 quantitative and 2 mixed-methods studies), 16 relating to antibiotics, 2 to antiseptic use, and 1 study to both antibiotic and antiseptic use. Most related to providers’ perspectives and were conducted in high-income countries. Key themes on factors affecting antibiotic use were providers’ beliefs about benefits and harms, perceptions of women’s risk of infection, regimen preferences and clinical decision-making processes. Studies on antiseptic use explored women’s perceptions of vaginal cleansing, and provider’s beliefs about benefits and the usefulness of guidelines. Conclusion We identified a range of factors affecting how providers use prophylactic antibiotics at birth, which can undermine implementation of clinical guidelines. There were insufficient data for low-resource settings, women’s perspectives, and regarding use of antiseptics, highlighting the need for further research in these areas. Implications for practice include that interventions to improve prophylactic antibiotic use should take account of local environments and perceived infection risk and ensure contextually relevant guidance.

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Section: Discussionmentioning

confidence: 99%

Factors affecting the use of antibiotics and antiseptics to prevent maternal infection at birth: A global mixed-methods systematic review

et al. 2022

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“…Existen estudios que evalúan la adherencia de los cirujanos a las guías de manejo en relación con la práctica quirúrgica (26); incluso se reportan de cada cirujano en el manejo quirúrgico para el cáncer de colon obstructivo en neoplasias de colon derecho, transverso, izquierdo, sigmoides y unión rectosigmoidea. Este formulario solo se podía diligenciar una vez, sin condicionar el número de instituciones en las que laborara el participante.…”

Section: Pronóstico Y Supervivenciaunclassified

Tendencias en el manejo quirúrgico de urgencia del cáncer de colon obstructivo. Situación departamental de Santander, Colombia, y consideraciones actuales

Guerrero-Macías

Bustos-Guerrero

Chaparro-Zaraza

2022

Rev. colomb. cancerol.

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Objetivos: Reportar las tendencias quirúrgicas de los cirujanos generales del departamento de Santander y analizar la situación regional para el cáncer de colon obstructivo en el escenario de urgencias. Métodos: Se recolectó información por medio de un cuestionario digital sobre la preferencia de cada cirujano general en el manejo quirúrgico para el cáncer de colon obstructivo en las diferentes localizaciones en el escenario de urgencias. Se describieron variables demográficas, así como la tendencia en las diferentes opciones de manejo. Se analizaron asociaciones entre las variables demográficas y la conducta quirúrgica a través del test chi cuadrado y el test exacto de Fisher. Resultados: Se incluyeron 32 cirujanos con edad media de 46,15 ± 11,48 años, 75% hombres, con 1 a 35 años de experiencia. Para obstrucciones del colon derecho, la tendencia fue realizar hemicolectomía derecha y anastomosis ileocólica (90,6%); para colon transverso, hemicolectomía del transverso y anastomosis (65,6%); en el caso del colon izquierdo, localizaciones más proximales llevaron a una tendencia equiparable para ostomías o anastomosis primaria (53,1% vs. 46,9% respectivamente) y para localizaciones más distales (sigmoides y unión rectosigmoidea), la tendencia es la realización de ostomías (78,1% vs. 100% respectivamente). El 71,9% de los cirujanos refiere realizar resección oncológica en el escenario de urgencias. En el análisis bivariado se encontró asociación entre la edad del cirujano y el tipo de procedimiento para las neoplasias obstructivas del colon derecho, con mayor tendencia (66%) a realizar ostomías en los cirujanos > 50 años. Conclusiones: La tendencia quirúrgica en el grupo de cirujanos del departamento de Santander está acorde con lo reportado en las guías de manejo internacionales en cuanto al manejo de tumores de colon derecho y transverso, con mayor tendencia a la resección y anastomosis primaria. Sin embargo, se identificó mayor preferencia a realizar ostomías en lesiones tumorales izquierdas distales. En general, las recomendaciones actuales van encaminadas a la resección y anastomosis en un primer tiempo quirúrgico en todos los escenarios; sin embargo, se deben tener en cuenta otros factores dependientes de cada paciente y el escenario hospitalario, independientes de la tendencia quirúrgica del cirujano.

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“…1 However, lack of adherence to follow protocol for SAP is among one of the factors for irrational use. 6,7 Bacteria that become resistant to multiple antibiotics are often the result of incorrect or prolonged antibiotic use. 8 30% to 50% of antibiotics prescribed in hospitals are for postsurgical prophylaxis, and almost 30% to 90% of these regimens are unnecessary.…”

Section: Introductionmentioning

confidence: 99%

“…These can be in the form of incorrect timing and duration of the prophylactic therapy. 6,10 Surgical antimicrobial prophylaxis lacks sufficient information and recommendations in India; hence there is an unmet need to collect baseline data. The purpose of this study was to examine the trend in the prescription of antimicrobial prophylaxis in various surgical specialties and apply the recommended SAP in a selected unit of surgery, and observe the outcomes of patients in that unit.…”

Section: Introductionmentioning

confidence: 99%

Protocol based Surgical Antimicrobial Prophylaxis in Endo-Urologic Surgeries: An Attempt to Convince the Surgeons to Follow the Guidelines

Ahmad¹,

Arsalan²,

Chaudhary³

et al. 2023

J. Pure Appl. Microbiol.

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Surgical antibiotic prophylaxis (SAP) prevents infectious complications during surgery by administering an effective antimicrobial agent before surgery. There is, however, lack of adherence to the standard SAP administration protocol. We reviewed 576 surgeries and find that cefuroxime/cefazolin was used as SAP in less than 31% of surgeries followed by ceftriaxone and cefoperazone. In 61% of cases, SAP was continued for more than 24 hours and in 2/3rd more than one SAP was prescribed, we noted the best SAP compliance was for the timing of pre-operative dosage. We then selected a unit of urology and applied the recommended SAP protocol, and monitored the patient’s outcome. All the surgeries were endoscopic urological procedures and our protocol was effective in 97.7% of patients. Out of 89, 78(87.6%) surgeries went uneventful, whereas 11 (12.4%) had post-operative complications. Two out of 89 (2.2%) cases had UTI post-operatively which was considered as surgical site infection. following the EAU guidelines for antibiotic prophylaxis reduced antibiotic use without increasing postoperative infection rates and SAP should be followed as per the standard guidelines in other units also. This small study is a way forward for our HICC team to motivate other surgeons to follow the guidelines and become antimicrobial stewardship champions. Our study demonstrates the feasibility of developing and successfully implementing such protocols.

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Factors that influence adherence to surgical antimicrobial prophylaxis (SAP) guidelines: a systematic review

Cited by 28 publications

References 101 publications

Factors affecting the use of antibiotics and antiseptics to prevent maternal infection at birth: A global mixed-methods systematic review

Factors affecting the use of antibiotics and antiseptics to prevent maternal infection at birth: A global mixed-methods systematic review

Tendencias en el manejo quirúrgico de urgencia del cáncer de colon obstructivo. Situación departamental de Santander, Colombia, y consideraciones actuales

Protocol based Surgical Antimicrobial Prophylaxis in Endo-Urologic Surgeries: An Attempt to Convince the Surgeons to Follow the Guidelines

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