The effect of antibiotic prophylaxis guidelines on surgical‐site infections associated with cesarean delivery

Skjeldestad, Finn Egil; Bjørnholt, Jørgen Vildershøj; Gran, Jon Michael; Erisken, Hanne-Merete

doi:10.1016/j.ijgo.2014.08.018

Cited by 11 publications

(8 citation statements)

References 15 publications

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“…Similar finding was observed in cesarean section [12]. Similar finding to ours had been reported in different settings and countries [13][14][15][16]. In our setting, one of the most important challenges was to overcome the previous experience of the staff and provide the best evidence regarding the proper use of antibiotics and to demonstrate the benefits of following it in terms of patient safety and more efficient use of the resources.…”

Section: Discussionsupporting

confidence: 89%

Quality of Perioperative Antibiotic Prophylaxis in a Community Hospital in Western Qatar

Guanche¹,

Villanueva²,

Nonato³

2017

J Infect Dis Epidemiol

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Objective: Describe the compliance with Antibiotic Prophylaxis (AP) in selected surgical procedures in a community hospital during a 3.5 year period. Methods:Descriptive study was carried out in a 75-bed public hospital in Western Qatar. The study included the patients underwent selected procedures who required antibiotic prophylaxis from Jan-2013 to June 2016. Data was collected by the infection control practitioner, from patient files to assess the compliance with timing, selection and dose and discontinuation of the antibiotic prophylactic as per policy, with a 100% compliance set as a program goal. The local infection control program mandates the monitoring of AP, feedback and staff education.Results: Data on 2386 procedures was collected. The 46.5% of the procedures were performed by general surgery, with lower frequency for trauma (24.4%), Gyn-Obst (17.8%) and plastic surgeries (11.3%). The compliance with timing and selection and dose was 61.1% and 94.4% during the first quarter, after which was observed figures over 98%. The discontinuation had the lowest figures during the quarter 2 to 4, with increased compliance over 99% after the quarter seven. Conclusion:Even when the compliance with antibiotic prophylaxis did not achieve the goals, especially for the timely administration, an increased adherence with guidelines was observed during the study period as a result of the strategy implemented by the infection control program. KeywordsAntibiotic prophylaxis, Surgical procedures, Compliance, Qatar is related with prolonged hospital stay, increased cost and other adverse outcomes [1,2]. The preventable outcomes of inappropriate antimicrobial use include infectious morbidity, sepsis-related mortality, and the incidence of Clostridium difficile infections and the emergence of antimicrobial resistant organisms [3].The guidelines emphasize on three key issues: The timely administration before surgical procedures, the selection of the antibiotics according to the expected microbial flora in the surgical site, the re-dosing schedule in specific conditions and the duration of the prophylaxis [2]. Published reports describe a variable compliance with guidelines and the effectiveness of an intervention for its improvement [4][5][6][7][8][9].In public health hospitals in Qatar, the antibiotic prophylaxis is guided by a corporate policy and the compliance is monitored by the infection control department. The aim of this study was to describe the compliance with antibiotic prophylaxis in selected surgical procedures in a community hospital during a 3.5 year period.

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Section: Discussionsupporting

confidence: 89%

Quality of Perioperative Antibiotic Prophylaxis in a Community Hospital in Western Qatar

Guanche¹,

Villanueva²,

Nonato³

2017

J Infect Dis Epidemiol

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“…Controversy regarding which HAI-related indicators are the best measures of performance and thus the most appropriate for public reporting has continued over the years (Tokars et al, 2004;Humphreys and Cunney, 2008). Relevant examples include deviceassociated infections, surgical prophylaxis, and SSI (Skjeldestad et al, 2015;Kilan et al, 2017;Pronovost et al, 2006). Nevertheless, expanding surveillance on other HAIs should also be taken into consideration, as a decline in device-and procedure-associated HAIs has been reported (Magill et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of healthcare-associated infections and antimicrobial use in China: Results from the 2018 point prevalence survey in 189 hospitals in Guangdong Province

Zhong

Chen

Zhou

et al. 2019

International Journal of Infectious Diseases

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Background: Limited data on healthcare-associated infections (HAIs) are available from the developing world, thus a point prevalence survey was conducted to determine the prevalence of HAIs and antimicrobial use in Guangdong Province, China. Methods: A standardized methodology for point prevalence surveys on HAIs and antimicrobial use has been developed by the Chinese Nosocomial Infection Control and Quality Improvement Center. The prevalence of HAIs, antimicrobial use, and baseline hospital-level variables were collected in 189 hospitals from June 2017 to May 2018. Results: Of 5 868 147 patients, 72 976 had one or more HAIs (1.24%), with 82 700 distinct HAIs. The prevalence rates of device-associated infections, including ventilator-associated pneumonia, catheterassociated urinary tract infection, and central line-associated bloodstream infection were 7.92, 2.06, and 0.63 per 1000 catheter-days, respectively. A total of 10 591 (0.18%) HAIs caused by multidrug-resistant organisms were identified. Carbapenem non-susceptibility rates were highest in Acinetobacter species (53.86%) and Pseudomonas aeruginosa (21.60%). Forty-six percent (2 712 258/5 868 147) of inpatients were receiving at least one antimicrobial during this survey. Conclusions: This survey indicated the relatively lower prevalence of HAIs but higher antimicrobial using in Guangdong Province compared with other mid to low-income and high-income countries. Further studies are warranted to elucidate which HAI-related indicators are the best measures of HAI performance and thus allow improvements leading to better patient outcomes.

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“…However, it cannot be concluded that the staff education was effective to reduce SSI because it was a group intervention. In term of the administration of a prophylactic antibiotic, a study found that the early administration of antibiotics, 2 to 24 hours into the pre-operative period was associated with the lowest risk of SSI (Skjeldestad, Bjornholt, Gran, & Erisken, 2015). In addition, it also found that hospitals that provided antibiotic prophylaxis to all women undergoing CS had reduced rates of superficial SSIs among the planned CS (Skjeldestad, Bjornholt, Gran, & Erisken, 2015).…”

Section: Risk Factorsmentioning

confidence: 99%

Surgical Site Infection among Women Post Cesarean Section: An Integrative Review

Novelia

Sia

Songwathana

2017

Nurs. Med. J. Nursing

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Background: Surgical site infection (SSI) in cesarean section (CS) is a major cause of prolonged hospital stay and resource consumption, and causes morbidity and mortality for the mother and the baby.Purpose: This literature review aimed to assess and identify risk factors, interventions, and prevention strategies of SSI for women post CS especially the obese women.Methods: An integrative literature review was conducted by employing the databases of PubMed, ProQuest, Science Direct, Wiley online library, and Google scholar from 1999 to 2015. This review identified the studies conducted either in women post-CS or obese women post CS.Results: A total of 58 articles were found, and 14 articles met the criteria. The risk factors of CS-SSI were classified into extrinsic and intrinsic factors. The intrinsic factors include limited mobility, poor nutrition, and comorbidity (diabetes) while the extrinsic factors include surgical technique, skin closure methods, prophylactic antibiotic, and the use of drains. Poor nutrition, diabetes, and limited mobility were the common factors found in obese women undergoing CS. Maintaining nutritional status and controlling blood glucose were proposed to prevent CS-SSI among obese women post-CS.Conclusions: Nurses should have adequate knowledge about the risk factors of CS-SSI to assess the risk factors of CS-SSI especially in obese women. The intervention of CS-SSI might need a bundle of interventions which consist of pre-operative and post-operative prevention strategies.

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The effect of antibiotic prophylaxis guidelines on surgical‐site infections associated with cesarean delivery

Abstract: Hospitals that provided antibiotic prophylaxis to all women undergoing CD reported high compliance and had reduced rates of superficial SSIs among planned CDs.

Cited by 11 publications

References 15 publications

Quality of Perioperative Antibiotic Prophylaxis in a Community Hospital in Western Qatar

Quality of Perioperative Antibiotic Prophylaxis in a Community Hospital in Western Qatar

Prevalence of healthcare-associated infections and antimicrobial use in China: Results from the 2018 point prevalence survey in 189 hospitals in Guangdong Province

Surgical Site Infection among Women Post Cesarean Section: An Integrative Review

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