Perioperative antibiotic prophylaxis: improved compliance and impact on infection rates

Abstract

The aims of this study were to determine adherence to the perioperative antibiotic prophylaxis (PAP) protocol used at a large Italian teaching hospital during a 6-year period, to assess the variables associated with inappropriate administration, and to measure the impact on surgical site infection (SSI) rates. There were 28 621 patients surveyed of which 74·6% received PAP. An improvement in adherence to the PAP protocol was registered for 58·8% of patients. Significant risk factors were an American Society of Anesthesiologists (ASA) score ≥ 2 [odds ratios (OR) from 1·28 (95% confidence interval (CI) 1·19-1·37) to 1·87 (95% CI 1·43-2·44)], prolonged duration of surgery (OR 1·68, 95% CI 1·56-1·82) and urgent surgery (OR 2·16, 95% CI 1·96-2·37). During the study period, a significant reduction in SSIs rates was detected. We concluded that the global reduction of inadequate PAP administration signifies the efficacy of a multidisciplinary quality improvement initiative on antimicrobial utilization, and this is supported by the observed reduction of the SSI rate.

Catheter-associated urinary tract infection: Role of the setting of catheter insertion

“…21 Compared with the data reported in the 2013 European Antimicrobial Resistance Surveillance Network report on antimicrobial resistance surveillance in Europe, 22 all the Pseudomonas isolates showed higher resistance levels for most antimicrobial categories tested, but they were all susceptible to colistin. Moreover, the European Antimicrobial Resistance Surveillance Network report for K pneumoniae combined resistance to third-generation cephalosporins, fluoroquinolones, aminoglycosides, and carbapenems in only 6.1% of isolates in Europe, whereas we found this pattern of resistance in all of the isolates.…”

Antimicrobial Prophylaxis in Instrumented Spinal Fusion Surgery: A Comparative Analysis of 24-Hour and 72-Hour Dosages

“…Although prophylaxis is an accepted practice, a debate exists with regard to the antibiotic type to be used and its administration duration for various surgical procedures. Appropriate antibiotic usage will help in reducing the emergence of drug resistance and will also avoid complications such as Clostridium difficile infection arising due to prolonged antibiotic use [5]. The purpose of this study was to compare the efficacy of 24-hour and 72-hour antibiotic prophylaxis in preventing SSIs.…”

Compliance of Perioperative Antibiotic Dosing and Surgical Site Infection Rate in Office-Based Elective Surgery

“…33 However, a noted flaw in the study was inconsistency in objective data recording. This is a real risk if there are no protocol reminders or checklists.…”