Antibiotic policies in surgery: a consensus paper

Stratchounski, L.; Taylor, Eric; Dellinger, E. Patchen; Péchère, Jean-Claude

doi:10.1016/j.ijantimicag.2005.07.002

Cited by 24 publications

(27 citation statements)

References 17 publications

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“…Antibiotic prophylaxis in surgery is one of the matters of discussion about hospital use of antimicrobial agents, since surgical procedures are often associated with unnecessary prescription of antibiotics. 17 International guidelines suggest that the more suitable antibiotics for prophylaxis are first-generation (cefazolin) or secondgeneration (cefuroxime) cephalosporins. 17,18 The third-and fourth-generation cephalosporins, carbapenems, aztreonam and fluoroquinolones are more expensive and promote the emergence of resistant strains, and they should not be used for routine prophylaxis in surgery.…”

Section: Discussionmentioning

confidence: 99%

“…17 International guidelines suggest that the more suitable antibiotics for prophylaxis are first-generation (cefazolin) or secondgeneration (cefuroxime) cephalosporins. 17,18 The third-and fourth-generation cephalosporins, carbapenems, aztreonam and fluoroquinolones are more expensive and promote the emergence of resistant strains, and they should not be used for routine prophylaxis in surgery. Our survey showed instead a very high, and probably inappropriate, consumption of these groups of antibiotics.…”

Section: Discussionmentioning

confidence: 99%

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A 3 year survey on the use of antibacterial agents in five Italian hospitals

Vaccheri

Silvani

Bersaglia

et al. 2008

Journal of Antimicrobial Chemotherapy

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Background: Misuse of antimicrobial agents in hospitals may cause the emergence of resistant microorganisms, as well as increased costs and unnecessary exposure of patients to drugs. We investigated the pattern of antibiotic consumption in 2002 -04 in a sample of Italian hospitals, and compared this with antibiotic consumption data in primary healthcare in the Emilia-Romagna region. Methods:The study was carried out in five hospitals of the Emilia-Romagna region and 2002-04 drug use data were obtained from the pharmacy services. Data were analysed by clinical areas and single wards and were expressed by ATC classification and defined daily doses (DDD)/100 bed days. Prescription data of antibacterials in primary care in the same period were also analysed.Results: Antibiotic consumption increased by 18% in the 3 year period. Combinations of penicillins and b-lactamase inhibitors were the most used drugs, followed by fluoroquinolones and thirdgeneration cephalosporins. Penicillins plus b-lactamase inhibitors increased in all the clinical areas by over 40%, and fluoroquinolones sharply increased in medical units (129%). Third-generation cephalosporins remained fairly stable in paediatrics and surgery, but increased in medicine (118%). Glycopeptides accounted for 4.3% of total antibiotic consumption with a peak of 10% in intensive care units. Antibacterial prescription in primary care showed a pattern similar to that of hospitals. Conclusions:We found a considerable increase in antibiotic use over time and a marked preference for wide-spectrum antibiotics such as penicillins plus b-lactamase inhibitors, fluoroquinolones and third-generation cephalosporins; thus raising concern about appropriate use. These results could represent the basis for educational initiatives aimed at rationalizing the use of antibiotics in hospitals.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A 3 year survey on the use of antibacterial agents in five Italian hospitals

Vaccheri

Silvani

Bersaglia

et al. 2008

Journal of Antimicrobial Chemotherapy

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“…The relationship between SSIs and factors such as age, gender, ASA (American Society of Anesthesiologists) scores, timing and site of surgery, type of wound, underlying diseases and antibiotic prophylaxis administration according to the protocol recommended by the control committee infectious of hospital. Patients were divided into four groups ( Table 1) according to the risk of contamination during surgery (6)(7)(8)(9)(10). The statistical analysis was done with using the SPSS (13.0) program.…”

Section: Methodsmentioning

confidence: 99%

Cerrahi Alan İnfeksiyonları ve Risk Faktörleri: Türkiye’de Doğu Anadolu Bölgesinde bir Devlet Hastanesinin Sonuçları

Çağlayan¹,

Bal²,

Balcı³

et al. 2016

Kocatepe Tıp Dergisi

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ÖZETAmaç: Cerrahi alan infeksiyonları (CAİ) cerrahiden sonra görülen major bir problemdir. Hasta konforunun bozulmasına, morbidite ve mortalite artışa, hastanede kalış sü-resinin uzamasına ve hastane maliyetlerinde artışa neden olurlar. Bu çalışmanın amacı cerrahi alan infeksiyonlarını etkileyen risk faktörlerini araştırmaktır. Materyal ve Metod: Bir devlet hastanesinde Kasım 2007ile Ağustos 2009 tarihleri arasında cerrahi uygulanan 1040 hasta; CAİ ve onunla ilişkili yaş, cinsiyet, ASA derecelendirmesi, anestezi tipi, cerrahinin zamanlaması ve böl-gesi, yara tipi ve altta yatan hastalık açısından retrospektif olarak incelendi. Bulgular:Hastaların yaşları 4 ile 82 yıl (ort. 36,1 ±15,8 yıl) arasında ve kadın/erkek oranı 43/57 idi. 1040 hastanın 53'ünde (% 5,1) CAİ tanısı konmuştu. CAİ gelişen vakaların % 39,2'sinde S. aureus izole edildi. CAİ gelişen hastaların ortalama yatış süresi 7 gün iken, gelişmeyen hastalarda bu oran 2,7 gün idi. Yaş, yara tipi, ASA skoru ve altta hastalıkla CAİ gelişmesi arasında anlamlı fark bulundu (p<0,05). Sonuç:Hastaların ameliyat sonrası CAİ oranları literatür ile uyumlu idi. Hastanın yaşı, ASA skoru, yara tipi ve ek hastalık varlığı faktörleri değiştirilmez. Ancak CAİ için risk ameliyat öncesi antibiyotik profilaksisi ile azaltılabilir.Anahtar Kelimeler: Cerrahi alan infeksiyonu, insidans, risk faktörleri. ABSTRACTObjective: Surgical site infections (SSIs) are a major problem after surgery. They cause to impairment of patient comfort, increase morbidity, mortality, in hospital stay and costs. The aim of this study is to investigate the risk factors affecting SSIs. Results: Patients ranged in age from 4 to 82 years (mean 36,1 ±15,8) and female to male ratio was 43/ 57. Of 1040 patients, 53 (5,1 %) had a diagnosis of SSI. The isolated pathogen in the 39,2 % of the patients who developed wound infection was S. aureus. The hospital stay was average 7 days in the patients developed SSI while it was 2,7 days in the patients without SSI. The age, wound type, ASA scores and underlying diseases were found significant in the development of SSIs (p<0,05). Material and Methods Conclusions:Postoperative wound infection rates in our patients were in compatible with literature. Patient's age, ASA score, wound type and the presence of additional disease are not changed factors but this risk can be reduced in patients with preoperative antibiotic prophylaxis.

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“…21 If one accepts the internationally adopted principle that prophylactic antibiotics should not be used in clean wounds with infection rates of below 1%, then it would be reasonable to recommend prophylactic antibiotics in patients with known risk factors with a risk of infection greater than 1%. 22 Many other factors may influence postoperative wound infections including preoperative hand and surgical site scrub technique, barrier materials, surgical glove damage, and specific epidemiologic settings such as local prevalence of methicillin-resistant Staphylococcus aureus. Postoperative wound infections cannot always be prevented even with use of antibiotics.…”

Section: My Current Conceptsmentioning

confidence: 99%

Perioperative Antibiotics for Carpal Tunnel Surgery

Szabo

2010

The Journal of Hand Surgery

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Antibiotic policies in surgery: a consensus paper

Cited by 24 publications

References 17 publications

A 3 year survey on the use of antibacterial agents in five Italian hospitals

A 3 year survey on the use of antibacterial agents in five Italian hospitals

Cerrahi Alan İnfeksiyonları ve Risk Faktörleri: Türkiye’de Doğu Anadolu Bölgesinde bir Devlet Hastanesinin Sonuçları

Perioperative Antibiotics for Carpal Tunnel Surgery

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