Evaluation of antibiotic prophylaxis for gastrointestinal surgeries in a teaching hospital: An interventional pre–post study

Surgical site infections are related to a high morbidity, mortality and healthcare costs. Despite ample evidence demonstrating the effectiveness of antimicrobials to prevent surgical site infections, inappropriate timing, antibiotic selection and excessive continuation of antibiotics are common in p...

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Published in:Journal of perioperative practice 2022-12, Vol.32 (12), p.354-360
Main Authors: Elyasi, Sepideh, Fattahi Masum, Asiyeh, Bahreyni, Amirhossein, Samani, Seyed Sattar, Atamanesh, Ahmad, Abdollahi, Abbas, Mousavi, Maryam
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Antibiotic Prophylaxis - methods
Antibiotics
Clinical decision making
Clinical practice guidelines
Digestive System Surgical Procedures
Disease prevention
Drug dosages
Evidence-based medicine
Gastrointestinal surgery
Hospitals, Teaching
Humans
Medical errors
Surgical site infections
Surgical Wound Infection - prevention & control
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Summary:Surgical site infections are related to a high morbidity, mortality and healthcare costs. Despite ample evidence demonstrating the effectiveness of antimicrobials to prevent surgical site infections, inappropriate timing, antibiotic selection and excessive continuation of antibiotics are common in practice. In this study, we compare the appropriateness of antibiotic prophylaxis in gastrointestinal surgery, before and after an evidence-based guideline implementation. One hundred patients were evaluated in each group. The implementation of the guideline resulted in significant reduction of incorrect use of antibiotics from 55% to 18% (P = 0.002). It also reduced duration of prophylactic antibiotics (43% vs. 23%, P = 0.025). Inappropriate doses diminished but not significantly (8% vs. 5%, P = 0.321). Based on our results, in more than half of of these cases patients received incorrect antibiotic prophylaxis regimens for gastrointestinal surgery in this hospital. Local guideline implementation can result in reduction of antibiotic use, dose and duration errors.
ISSN:1750-4589
2515-7949
DOI:10.1177/1750458919825583