Perioperative Antibiotic Prophylaxis: Surgeons as Antimicrobial Stewards

Miranda, David; Mermel, Leonard A.; Dellinger, E. Patchen

doi:10.1016/j.jamcollsurg.2020.08.767

Cited by 16 publications

(22 citation statements)

References 33 publications

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“…Current antimicrobial prophylaxis in surgery guidelines recommend that the duration of SAP should not beyond 24 h after incision for clean procedures [22]. However, in almost 10% of the procedures in our study, the duration of SAP exceeded this time limit.…”

Section: Strengths and Limitationsmentioning

confidence: 55%

Sustained improvement of appropriateness in surgical antimicrobial prophylaxis with the application of quality control circle

Zou¹,

Zhong²,

Liu³

et al. 2022

Preprint

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Administration of surgical antimicrobial prophylaxis (SAP) is considered one of the most effective measures to reduce the incidence of surgical site infection (SSI) after various surgical procedures. Quality control circle (QCC) has acquired success in many fields in healthcare industry as a process management tool, whereas its efficacy in SAP remains unknown. Our present study utilized the QCC activity to improve the appropriate administration of SAP. A QCC activity team was established to grasp the current situation of SAP in clean surgery procedure, set target, formulated corresponding countermeasures and implement and review them in stages. The plan-do-check-act (PDCA) method was cyclically applied. The appropriateness of SAP before (July to December 2018) and after (January to June 2019) the implementation of QCC activities were evaluated based on relevant international and Chinese SAP guidelines. The appropriate rate of SAP was significantly improved from 68.72% before QCC to 93.7% post QCC implementation (P༜0.01). A significant improvement (P༜0.05) was also determined for each category: selection (from 78.82 to 96.06%), duration (from 90.15 to 96.46%), indication (from 94.09 to 97.64%), timing of first dose (from 96.55 to 99.21%), antimicrobial usage (from 96.8 to 99.41%), re-dosing of antimicrobial (from 96.55 to 99.21%). The appropriate application of SAP is improved through QCC activities, providing a useful reference for the prevention of antimicrobial misuse and overuse.

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Section: Strengths and Limitationsmentioning

confidence: 55%

Sustained improvement of appropriateness in surgical antimicrobial prophylaxis with the application of quality control circle

Zou¹,

Zhong²,

Liu³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…However, in almost 10% of the procedures in our study, the duration of PAP exceeded this time limit. Previous studies demonstrated that prolonged PAP can alter the institutional antibiogram and an individual's microbiome, which can lead to the emergence of bacterial resistance and may increase the incidence of antibiotic-associated complications [22,23]. Other studies revealed that a single intravenous dose or within 24 h administration of PAP is enough to prevent postoprerative infection in clean operations [23].…”

Section: Discussionmentioning

confidence: 99%

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

Zou¹,

Zhong²,

Liu³

et al. 2022

Preprint

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Background: Appropriate implementation of perioperative antimicrobial prophylaxis in surgery is considered an effective measure to prevent the incidence of surgical site infection and the emergence of antimicrobial-resistant bacteria. To reduce the emergence of antimicrobial-resistant bacteria, there is a need to improve the correct implementation of PAP. Methods: A QCC activity team was established to grasp the current situation of PAP in clean surgery procedure, set target, formulated corresponding countermeasures and implement and review them in stages. The plan-do-check-act method was cyclically applied. The appropriateness of PAP before (July to December 2018) and after (April to September 2019) the implementation of QCC activities were evaluated based on relevant international and Chinese perioperative antimicrobial prophylaxis guidelines. Results: The appropriate rate of PAP was significantly improved from 68.72% (n=406) before QCC to 93.7% (n=508) post QCC implementation (P＜0.01). A significant improvement (P＜0.05) was also determined for each category: selection (from 78.82 to 96.06%), duration (from 90.15 to 96.46%), indication (from 94.09 to 97.64%), timing of first dose (from 96.55 to 99.21%), antibiotic usage (from 96.8 to 99.41%), re-dosing of antibiotic (from 96.55 to 99.21%). Conclusions: The appropriate application of PAP is improved through QCC activities, providing a useful reference for the prevention of antimicrobial-resistant bacteria and the development of medical quality improvement activities.

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“…However, in almost 10% of the procedures in our study, the duration of PAP exceeded this time limit. Previous studies demonstrated that prolonged PAP can alter the institutional antibiogram and an individual's microbiome, which can lead to the emergence of bacterial resistance and may increase the incidence of antibiotic-associated complications [22,23] . Other studies revealed that a single intravenous dose or within 24 h administration of PAP is enough to prevent postoprerative infection in clean operations [23] .…”

Section: Discussionmentioning

confidence: 99%

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

Zou¹,

Zhong²,

Liu³

et al. 2022

Preprint

View full text Add to dashboard Cite

The present study aimed to exam the effect of quality control circle (QCC) activities on promoting the appropriate implementation of preoperative antibiotic prophylaxis in clean surgery. A QCC activity team was established to grasp the current situation of PAP in clean surgery procedure, set target, formulated corresponding countermeasures and implement and review them in stages. The plan-do-check-act method was cyclically applied. The appropriateness of PAP before (July to December 2018) and after (April to September 2019) the implementation of QCC activities were evaluated based on relevant international and Chinese perioperative antimicrobial prophylaxis guidelines. The appropriate rate of PAP was significantly improved from 68.72% (n=406) before QCC to 93.7% (n=508) post QCC implementation (P＜0.01). A significant improvement (P＜0.05) was also determined for each category: selection (from 78.82 to 96.06%), duration (from 90.15 to 96.46%), indication (from 94.09 to 97.64%), timing of first dose (from 96.55 to 99.21%), antibiotic usage (from 96.8 to 99.41%), re-dosing of antibiotic (from 96.55 to 99.21%). The appropriate application of PAP is improved through QCC activities, providing a useful reference for the prevention of antimicrobial-resistant bacteria and the development of medical quality improvement activities.

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Perioperative Antibiotic Prophylaxis: Surgeons as Antimicrobial Stewards

Cited by 16 publications

References 33 publications

Sustained improvement of appropriateness in surgical antimicrobial prophylaxis with the application of quality control circle

Sustained improvement of appropriateness in surgical antimicrobial prophylaxis with the application of quality control circle

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

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

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