Surgical site infections (SSIs) are the most common and costliest healthcare-associated infections. Antibiotic prophylaxis plays an important role in preventing SSIs, especially for clean and clean -contaminated wounds. Despite evidence of effectiveness and availability of guidelines, antibiotic prophylaxis adherence is often suboptimal. This descriptive cross-sectional study was conducted on 311 medical records of patients undergoing surgeries with clean or cleancontaminated wounds at 5 surgery departments at University Medical Center from January to April, 2017. The appropriateness of antibiotic prophylaxis usage was assessed using guidelines from ASHP, Vietnam's Ministry of Health or University Medical Center. Antibiotic prophylaxis was indicated in 99.3% of cases. The mean duration of postoperative use was 3.4 ± 2.6 days. Overall adherence to antibiotic prophylaxis guidelines was observed in 4.8% of procedures. The proportion of cases with appropriate adherence to antibiotic choice, dosing, timing of the first dose, redosing and duration of prophylaxis were 34.1%, 64.0%, 92.0%, 94.2% and 49.2%, respectively. Department of Obstetrics and Gynaecology, wound classification, length of surgery, antibiotics covered by Health Insurance were found to be significantly associated with the appropriateness of antibiotic choice. Adherence to antibiotic prophylaxis guidelines at University Medical Center was low within the study period. The Antibiotic stewardship program should be enhanced and actions to ensure Health Insurance coverage for all antibiotics used for prophylaxis should be implemented to improve the effectiveness and appropriateness of antibiotic prophylaxis.

Thyroid hormones, including 3,5,3′-triiodothyronine (T3), cause a wide spectrum of genomic effects on cellular metabolism and bioenergetic regulation in various tissues. The non-genomic actions of T3 have been reported but are not yet completely understood. Acute T3 treatment significantly enhanced basal, maximal, ATP-linked, and proton-leak oxygen consumption rates (OCRs) of primary differentiated mouse brown adipocytes accompanied with increased protein abundances of uncoupling protein 1 (UCP1) and mitochondrial Ca2+ uniporter (MCU). T3 treatment depolarized the resting mitochondrial membrane potential (Ψm) but augmented oligomycin-induced hyperpolarization in brown adipocytes. Protein kinase B (AKT) and mammalian target of rapamycin (mTOR) were activated by T3, leading to the inhibition of autophagic degradation. Rapamycin, as an mTOR inhibitor, blocked T3-induced autophagic suppression and UCP1 upregulation. T3 increases intracellular Ca2+ concentration ([Ca2+]i) in brown adipocytes. Most of the T3 effects, including mTOR activation, UCP1 upregulation, and OCR increase, were abrogated by intracellular Ca2+ chelation with BAPTA-AM. Calmodulin inhibition with W7 or knockdown of MCU dampened T3-induced mitochondrial activation. Furthermore, edelfosine, a phospholipase C (PLC) inhibitor, prevented T3 from acting on [Ca2+]i, UCP1 abundance, Ψm, and OCR. We suggest that short-term exposure of T3 induces UCP1 upregulation and mitochondrial activation due to PLC-mediated [Ca2+]i elevation in brown adipocytes.