493 Audit of Antibiotic Prescriptions in Appendicectomies and Adherence of Surgeons to National and Local Trust Guidelines: Preoperative and Postoperative

Abstract

Abstract Aim To investigate adherence of antibiotic prescriptions to national and local standards in appendicectomies, pre-operative & post operative, in a district general hospital. BMJ Best Practice standards state that all patients should be given prophylactic antibiotics preoperatively, but only complicated cases (perforation and/or abscess and/or acutely unwell) need to be given postoperative antibiotics. Adherence to local prophylactic antibiotic guidelines was also assessed. Trust antimicrobial guidelines are freely available on the MicroGuide mobile application - https://tinyurl.com/gastrosurg. Method A retrospective audit conducted in a district general hospital. A 6-month audit of antibiotic prescriptions in appendicectomies to investigate adherence rate to national and local standards. The important information was collected from the trust’s electronic patient record through a predesigned Pro forma. Results A total of fifty patients (patients with penicillin allergy; n = 4; 8%) underwent an appendectomy between June 2022 and November 2022 in a district general hospital. 100% of patients were given prophylactic antibiotics. However, only 25% of cases of penicillin allergy and 2.2% of cases with no penicillin allergy were given prophylactic antibiotics that adherent to trust policy. Complicated cases comprised 30% of cases. 100% of complicated cases had postoperative antibiotics while 80% of uncomplicated cases had postoperative antibiotics unnecessarily. Conclusions This audit cycle showed poor adherence to national and local antimicrobial standards. Action plan includes presenting results in the monthly surgical audit meeting, increase awareness of the MicroGuide app and BMJ Best Practice standards and reaudit to enhance adherence to antimicrobial guidelines.