Post-graduation intervals related to nonstandard preoperative antibiotic prophylaxis in gynecological procedures and surgical site infection

Abstract

Objective Pre-operative antibiotic prophylaxis guideline has been endorse in many institute aims to reduce surgical site infection. Our study conducted to identify the rate of appropriate antibiotic prophylaxis in gynecological procedures based on American College of Obstetrics and Gynecology’s recommendations. And to determine the relevant factors for surgical site infection (SSI). Study design A retrospective case-control study. Results Total 112 procedures were studied and found 5.3% rate of SSI. The risk factors for SSI were inappropriate antibiotic use (12% vs 0%, P=0.01), higher age (45 vs 56.5 years, P=0.01), higher body mass index (30.32 vs 24.35 kg/m2, P=0.02), higher fasting blood sugar (129 vs 96 mg/dL, P=0.01), having medical comorbidities with diabetes and/or hypertension (P=0.01), and post-menopausal status (16.7% vs 1.2%, P=0.01). The procedural factors significantly related to SSI were performing procedures in nonoffice hours (13.8% vs 2.4%, P=0.04), surgery for cancer conditions (20% vs 1.1%, P<0.01). The rate of inappropriate antibiotic prophylaxis was 43.8%. The postgraduation interval of more than 3 years was significantly associated with inappropriate antibiotic prophylaxis (55.8% vs 36.2%, P=0.04). Conclusion The overall rate of SSI was 5.3% following gynecological procedures. Risk factors for infection were being elderly, higher BMI, higher fasting blood sugar, having medical comorbidities (diabetes and/or hypertension), post-menopausal status, non-office hour procedures, and cancer surgery. Rate of nonstandard preoperative antibiotic prophylaxis was 43.8% and significantly related to SSI. Endorsing standard recommendations on antibiotic prophylaxis is one of the modifiable factors for SSI prevention. A postgraduation interval longer than 3 years was significantly related to nonstandard antibiotic usage.