Abstract
Little is known regarding the factors associated with surgical antibiotic prophylaxis (SAP) compliance in elective minor surgery. The purposes of this cross-sectional study were to identify the frequency of inappropriate SAP administration and to understand the characteristics associated with such inappropriateness in a sample of elective minor surgical procedures. The study was performed between May and July 2019 among a random sample of patients aged 18 years and older in seven public hospitals randomly selected in the Campania and Calabria Regions of Italy. Globally, only 45% of SAP approaches were deemed completely in accordance with the evidence-based guidelines. Patients with an ordinary admission, those who underwent local anesthesia, those receiving plastic and reconstructive and ophthalmology surgery, and those who had not received a prosthetic implant were more likely to receive an appropriate SAP approach; those receiving obstetrics, gynecological, and urological surgical procedures were less likely than those who underwent abdominal, vascular, and breast surgery. The course of antibiotic prophylaxis was not consistent with the guidelines in 48.5% procedures with one or more reasons for inappropriateness. Appropriate time of the SAP administration was more frequently observed in patients who were older, those with a Charlson comorbidity index of 0, those who did not receive a prosthetic implant, and those receiving plastic and reconstructive surgery; it was less likely in patients receiving obstetrics, gynecological, and urological surgeries compared with those who underwent abdominal, vascular, and breast surgery. Aspects of SAP that need to be improved are molecule choice, time of administration, and specific surgical procedures. Hospital managers should involve surgeons and anesthesiologists in initiatives tailored to optimize SAP prescribing.
Highlights
IntroductionSurgical site infections (SSIs) are among the most common healthcare-associated infections (HAI)
Surgical site infections (SSIs) are among the most common healthcare-associated infections (HAI)and are associated with longer post-operative hospital stays, additional surgical procedures, treatment in an intensive care unit, and higher mortality [1]
More than half were females, the mean age was 61.7 years, 66.8% had at least one chronic disease, 10.3% self-reported the use of antibiotics in the previous month, 72.8% were admitted in surgical specialty wards, 62.1% had an ordinary admission, 79.4% of the procedures were clean, the mean duration of surgery was 23 min, and the majority of the interventions was under local anesthesia (Table 1)
Summary
Surgical site infections (SSIs) are among the most common healthcare-associated infections (HAI). Are associated with longer post-operative hospital stays, additional surgical procedures, treatment in an intensive care unit, and higher mortality [1]. Has to be implemented prior to a procedure for the prevention of these infections at the surgical site [2]. Antibiotics 2020, 9, 713 stewardship efforts in hospital settings [5,6,7]. Guidelines on the administration of SAP have been published [8,9] and indication, molecule choice, timing, and duration are essential components of hospital-based antimicrobial stewardship programs. It is crucial to determine the occurrence of an indication, to select the appropriate agent that covers the likely pathogens on wound contamination, and to administer sufficient bactericidal concentrations for the whole period during which the incision is open and at risk of contamination [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
