Adherence to guidelines for antibiotic prophylaxis in general surgery: a critical appraisal

Tourmousoglou, Christos; Yiannakopoulou, Eugenia; Kalapothaki, V.; Bramis, J.; Papadopoulos, J. St.

doi:10.1093/jac/dkm406

Cited by 136 publications

(160 citation statements)

References 16 publications

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“…However, this result is close to those found by other authors, whose rates varied between 81% and 88.1% 16,17,20,27 . .…”

Section: Assessment Of Antibiotic Prophylaxis In Surgical Patients Atsupporting

confidence: 92%

“…, Tourmousoglou et al 16 , Pitallis et al 15 and Hohmann et al 25 showed contrasting results with the present study, the values being 5.8%, 20%, We must note the current trend of antibiotic prophylaxis restricted to surgical time 9 .…”

contrasting

confidence: 77%

“…to 97.5% [14][15][16] . However, other articles showed results inferior to the aforementioned frequencies, with a variation for the use of the antibiotic prophylaxis in the range of 58% to 73% [17][18][19] .…”

Section: Resultsmentioning

confidence: 99%

“…The result of multivariate analysis suggests that the outcome could not be associated with any independent variable, since there was no significant variability in this outcome frequency, that is, discontinuation of the antibiotic was performed in due time in most patients (95.7% cases). However, Wright et al 27 noted that groups of patients who more often received antibiotics for a long time were those with more comorbidities or elderly females.Surgical antibiotic prophylaxis may be considered appropriate when it reaches values of the criteria established in the adopted protocols close to 100%.From 11 analyzed articles that addressed appropriate surgical antibiotic prophylaxis, this parameter was considered inadequate in 100% of them [14][15][16][17]20,21,[23][24][25]28,30 . In their systematic review of adherence to surgical antibiotic prophylaxis protocols, Gouvêa et al 35 concluded that all the studies reviewed indicated the need for greater adherence to such protocols.…”

mentioning

confidence: 99%

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Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital.

Gouvêa

Novaes

Iglesias

2016

Rev. Col. Bras. Cir.

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Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital. Avaliação da antibioticoprofilaxia em pacientes cirúrgicos no HospitalUniversitário Gaffrée e Guinle. This complication is one of the main forms of infections related to health care in Brazil, as demonstrated in a study conducted by the Ministry of Health, which observed SSI in 11% of all surgical procedures analyzed 4 . SSI occupies the third place in frequency among all the others, accounting for about 15% of all infectious processes observed in hospitalized patients 2,5 .Moreover, this type of complication involves financial burden to the patient, to the hospital and to the healthcare system. These facts make SSI an important public health problem and therefore a target for improving the quality of care to the patient who is candidate to surgical treatment 6 .Antibiotic prophylaxis is part of a set of measures that aim to reduce SSI incidence. The main aim of antibiotic prophylaxis is to reduce the bacterial load in the wound, to assist the natural host defenses in preventing SSI Efforts have been undertaken to establish protocols to guide the appropriate use of antibiotic prophylaxis for SSI prevention, whose goal is to provide health professionals with a standardized approach to the safe, effective and rational use of antimicrobials 9 .The aim of this study was to evaluate the use of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital, in the city of Rio de Janeiro. Gouvêa Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital METHODSThis is a prospective study of a cohort composed of patients undergoing elective surgical procedures between January and September 2014. Of the 283 patients who were initially candidates to participate in the study, we excluded 27 because they do not meet the established criteria, the final sample thus comprising 256 cases.We conducted the study at the Gaffrée e Guin- The sample calculation considered the likelihood of appropriate use of antibiotic prophylaxis to 50%, with 95% confidence interval, and type I error <5%.Thus, the estimated sample of 232 patients.Data collection included three different times:preoperative time, perioperative one and up to the seventh postoperative day; we performed the record in a standardized form. In cases of administered antibiotic, we STATISTICAL ANALYSISWe performed univariate analyzes by means of simple frequencies in order to describe the study sample, and bivariate analysis to detect differences in the distribution of independent variables for each outcome of interest, using the chi-square test. We also employed multivariate logistic regression, including the indepen- RESULTSThe characteristics of the sample represented by the 256 patients studied and the analyzed outcomes are shown in Tables 1, 2 and 3. Most patients were female (64.8%). The age ranged from 19 to 90 years, with a mean age of 52.9±16.2 and with a predominance of non-elderly (62.1%).Rega...

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“…However, this result is close to those found by other authors, whose rates varied between 81% and 88.1% 16,17,20,27 . .…”

Section: Assessment Of Antibiotic Prophylaxis In Surgical Patients Atsupporting

confidence: 92%

contrasting

confidence: 77%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital.

Gouvêa

Novaes

Iglesias

2016

Rev. Col. Bras. Cir.

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“…Several studies assessing compliance with surgical prophylaxis guidelines in hospitals abroad have been published [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Overall compliance to guidelines has varied from as low as 0-53%, usually in the range of 20-30%.…”

Section: Discussionmentioning

confidence: 99%

How good is compliance with surgical antibiotic prophylaxis guidelines in a tertiary care private hospital in India? A prospective study

Parulekar¹,

Soman

Singhal

et al. 2009

Indian J Surg

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Purpose There is a need to study compliance with surgical antibiotic prophylaxis guidelines in India.Methods In this prospective study, 100 consecutive surgical procedures performed at a tertiary care private hospital in Mumbai, India were observed. The choice of antibiotic, timing and duration of administration were recorded and compared to the hospital guidelines.Results Appropriateness of choice of antibiotic was seen in 68%, timing in 89%, dose in 75% and duration in 63% of cases. Hundred percent compliance to all criteria was observed in 52% of cases. The SSI rate was 3.3%.Conclusions These compliance rates though suboptimal are similar to those reported in world literature. There is an urgent need to improve compliance with optimal surgical antibiotic prophylaxis guidelines so as to reduce risk of SSI and to prevent resistance and costs potentially associated with antibiotic misuse.

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Appropriateness of Surgical Antimicrobial Prophylaxis Practices in Australia

et al. 2019

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Key PointsQuestionWhat are the current surgical antimicrobial prophylaxis prescribing practices in Australia, and what factors are associated with their appropriateness?FindingsThis quality improvement study of 9351 surgical episodes found high rates of inappropriate procedural and postprocedural antimicrobial use across various hospital, patient, and surgical factors. The most common reason for inappropriate procedural use was incorrect timing, while duration greater than 24 hours was the most common reason for inappropriate postprocedural use.MeaningThese findings suggest that the identified hospital, patient, and surgical factors should be considered as targets for development of tailored interventions to ensure appropriateness of surgical antimicrobial prophylaxis prescriptions.

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Adherence to guidelines for antibiotic prophylaxis in general surgery: a critical appraisal

Cited by 136 publications

References 16 publications

Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital.

Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital.

How good is compliance with surgical antibiotic prophylaxis guidelines in a tertiary care private hospital in India? A prospective study

Appropriateness of Surgical Antimicrobial Prophylaxis Practices in Australia

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