Noncompliance with surgical antimicrobial prophylaxis guidelines: A Jordanian experience in cesarean deliveries

Jalil, Mariam Abdel; Hammour, Khawla Abu; Alsous, Mervat; Hadadden, Rand; Awad, Wedad; Bakri, Faris G.; Fram, Kamil

doi:10.1016/j.ajic.2017.06.033

Cited by 24 publications

(25 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Antibiotic selection was consistent with ASHP in 98.07% of patients receiving PAP and the correct drug dose was administered to 94.27%; these results were similar to those obtained by Abdel Jalil et alt. [17]. CPG-Ecuador does not recommend specific antibiotics, which could favour the use of a wide range of therapeutic schemes, as observed in this study.…”

Section: Papmentioning

confidence: 66%

“…Compliance with PAP is an important factor in reducing the incidence of SSI and avoiding the costs associated with it [13]. As in other non-infected surgical acts, antibiotic prophylaxis is recommended for all caesarean deliveries unless the patient is already receiving an antibiotic regimen for another existing infectious entity [10,12,[14][15][16][17][18]. However, in our study only 569 patients (69.90%) received…”

Section: Discussionmentioning

confidence: 94%

“…Other studies have also shown the inappropriate duration of PAP and the use of different therapeutic schemes that are poorly described and unnecessary [7,20]. In patients with blood loss greater than 1.5 L or who had prolonged surgery (more than 4 h) the duration of prophylaxis, as in the rest of the patients, was approximately 7 days, in contrast to what was stated in the literature [12,16,17].…”

Section: Papmentioning

confidence: 95%

See 2 more Smart Citations

Compliance with antibiotic prophylaxis guidelines in caesarean delivery: a retrospective, drug utilization study (indication-prescription type) at an Ecuadorian hospital.

Viamonte

Tames²,

Correa

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Preoperative antibiotic prophylaxis is essential for preventing surgical site infection (SSI). The aim of this study was to evaluate compliance with international and local recommendations in caesarean deliveries carried out at the Obstetrics and Gynaecology Service of the Ambato General Hospital, as well as any related health and economic consequences. Methods A retrospective indication-prescription drug utilization study was conducted using data from caesarean deliveries occurred in 2018. A clinical pharmacist assessed guidelines compliance based on the following criteria: administration of antibiotic prophylaxis, antibiotic selection, dose, time of administration and duration. The relationship between the frequency of SSI and other variables, including guideline compliance, was analysed. The cost associated with the antibiotic used was compared with the theoretical cost considering total compliance with recommendations. Descriptive statistics, Odds Ratio and Pearson Chi Square were used for data analysis by IBM SPSS Statistics version 25. Results The study included 814 patients with an average age of 30.87 ± 5.50 years old. Among the caesarean sections, 68.67% were emergency interventions; 3.44% lasted longer than four hours and in 0.25% of the deliveries blood loss was greater than 1.5 L. Only 69.90% of patients received preoperative antibiotic prophylaxis; however, 100% received postoperative antibiotic treatment despite disagreement with guideline recommendations (duration: 6.75 ± 1.39 days). The use of antibiotic prophylaxis was more frequent in scheduled than in emergency caesarean sections (OR=2.79, P=0.000). Nevertheless, the timing of administration, antibiotic selection and dose were more closely adhered to guideline recommendations. The incidence of surgical site infection was 1.35%, but tended to increase in patients who had not received preoperative antibiotic prophylaxis (OR=1.33, P=0.649). Also, a significant relationship was found between SSI and patient age (Chisq=8.08, P=0.036). The mean expenditure on antibiotics per patient was 5.7 times greater than that the cost derived from compliance with international recommendations. Conclusions Surgical antibiotic prophylaxis compliance was far below guideline recommendations, especially with respect to implementation and duration. This not only poses a risk to patients but leads to unnecessary expenditure on medicines. Therefore, this justifies the need for educational interventions and the implementation of institutional protocols involving pharmacists.

show abstract

Section: Papmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 94%

Section: Papmentioning

confidence: 95%

See 1 more Smart Citation

Compliance with antibiotic prophylaxis guidelines in caesarean delivery: a retrospective, drug utilization study (indication-prescription type) at an Ecuadorian hospital.

Viamonte

Tames²,

Correa

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The most frequent deviation from the guidelines was extended administration of prophylactic antibiotics (88.2%) of the study population. They recommended to give a central role to hospital pharmacists in managing the practice of surgical antibiotic prophylaxis [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Consumption and Resistance in a Tertiary Care Hospital in Jordan: Results of an Internet-Based Global Point Prevalence Survey

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: The Global Point Prevalence Survey (Global-PPS) provides a standardised method to conduct surveillance of antimicrobial prescribing and resistance at hospital level. The aim of the present study was to assess antimicrobial consumption and resistance in a Jordan teaching hospital as part of the Global-PPS network. Methods: Detailed antimicrobial prescription data were collected according to the Global Point Prevalence Survey protocol. The internet-based survey included all inpatients present at 8:00 am on a specific day in June–July 2018. Resistance data were based on microbiological results available on the day of the PPS. Results: Data were collected for 380 patients admitted to adult wards, 72 admitted children, and 36 admitted neonates. The overall prevalence of antimicrobial use in adult, paediatric, and neonatal wards was 45.3%, 30.6%, and 22.2% respectively. Overall, 36 patients (7.4%) were treated for at least one healthcare-associated infection (HAI). The most frequent reason for antimicrobial treatment was pneumonia. Cephalosporins and carbapenems were most frequent prescribed among adult (50.6%) and paediatric/neonatal wards (39.6%). Overall resistance rates among patients treated for a community or healthcare-associated infection was high (26.0%). Analysis of antibiotic quality indicators by activity revealed good adherence to treatment guidelines but poor documentation of the reason for prescription and a stop/review date in the notes. Conclusion: The present study has established baseline data in a teaching hospital regarding the quantity and quality of prescribed antibiotics in the hospital. The study should encourage the establishment of tailor-made antimicrobial stewardship interventions and support educational programs to enhance appropriate antibiotic prescribing.

show abstract

“…Diversas publicaciones internacionales describen un porcentaje variable de adecuación de la profilaxis antibiótica quirúrgica, que oscila entre 73,5% (con una reducción significativa en la incidencia de ISQ en este grupo), 70,7% en un estudio en el que la profilaxis era controlada por farmacéuticos, hasta tan solo 2,7% en cesáreas. Asimismo, los motivos de inadecuación fueron diversos ( 14 - 16 ).…”

unclassified

Estudio multicéntrico de adherencia a guías de profilaxis quirúrgica y sus determinantes en Argentina

Rodríguez

Clara

Klajn

et al. 2020

Revista Panamericana De Salud Pública

View full text Add to dashboard Cite

Objetivo. Evaluar el nivel de adherencia a las guías de profilaxis quirúrgica (AG) en instituciones de salud de Argentina y los determinantes de la falta de adherencia (NA). Métodos. Estudio multicéntrico de corte transversal en 35 centros de Argentina. Se determinaron el nivel de AG y las formas de NA y se comparó según características de la indicación antibiótica, anestesista, cirugía, institución y edad del paciente. Se ajustó un modelo de regresión logística. Resultados. Se revisaron 1 083 procedimientos quirúrgicos (PQ). La AG fue de 67%. Las formas más frecuentes de NA fueron: antibiótico incorrecto (28,9%), profilaxis innecesaria (25,5%) y profilaxis prolongada (24,4%). La AG fue mayor en menores de 18 años (84,9% frente a 65,5%, P < 0,001); según la dependencia (obra social, privada, pública o comunitaria) fue de 33,3%, 64,4%, 78,8% y 83,3%, respectivamente; P < 0,001) y según la población (maternoinfantil, pediátrica, con patología específica y general) fue de 97,9%, 97,2%, 89,4% y 63,2%, respectivamente; P < 0,001). La AG fue mayor en neurocirugía (91,1%), obstetricia (82,4%) y cirugía cardiovascular (CCV) (72,9%) y menor en otorrinolaringología (ORL) (47,8%), oftalmología (50%) y urología (55,9%) (P < 0,001). El análisis ajustado mostró mayor AG en menores de 18 años (odds ratio [OR]: 4,97; intervalo de confianza de 95% [IC95]: 1,13-21,80), cirugía de urgencia (OR: 2,18; IC95: 1,11- 4,26) e institución pública, privada o de comunidad (OR: 9,35; IC95: 3,85-22,70). La AG también fue mayor en instituciones para población maternoinfantil o específica (OR: 10,52; IC95, 1,30-85,12), CCV, neurocirugía, obstetricia (OR: 2,73; IC95: 1,55-4,78) e instituciones con programas para la optimización del uso de antimicrobianos (PROA) (OR 1,95; IC95, 1,10-3,45). Conclusiones. LA AG fue de 67%; el uso incorrecto, innecesario y prolongado del antibiótico fueron las formas más frecuentes de NA. La AG fue mayor con menor edad, PROA, dependencia privada o pública y población pediátrica o específica, PQ de urgencia y ciertas especialidades.

show abstract

Noncompliance with surgical antimicrobial prophylaxis guidelines: A Jordanian experience in cesarean deliveries

Cited by 24 publications

References 25 publications

Compliance with antibiotic prophylaxis guidelines in caesarean delivery: a retrospective, drug utilization study (indication-prescription type) at an Ecuadorian hospital.

Compliance with antibiotic prophylaxis guidelines in caesarean delivery: a retrospective, drug utilization study (indication-prescription type) at an Ecuadorian hospital.

Antimicrobial Consumption and Resistance in a Tertiary Care Hospital in Jordan: Results of an Internet-Based Global Point Prevalence Survey

Estudio multicéntrico de adherencia a guías de profilaxis quirúrgica y sus determinantes en Argentina

Contact Info

Product

Resources

About