Optimization of appropriate antimicrobial prophylaxis in general surgery: a prospective cohort study.

Autor: Doğan CZ; Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06230, Ankara, Turkey., Yalçın N; Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06230, Ankara, Turkey. nadir.yalcin@hotmail.com., Cennet Ö; Department of General Surgery, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey., Metan G; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey., Demirkan K; Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06230, Ankara, Turkey., Yorgancı K; Department of General Surgery, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey.
Jazyk: angličtina
Zdroj: European journal of medical research [Eur J Med Res] 2024 Jun 19; Vol. 29 (1), pp. 340. Date of Electronic Publication: 2024 Jun 19.
DOI: 10.1186/s40001-024-01938-w
Abstrakt: Background: Surgical site infections (SSI) are characterized by infections occurring in the surgical incision site, organ or cavity in the postoperative period. Adherence to surgical antimicrobial prophylaxis (SAP) is paramount in mitigating the occurrence of SSIs. In this study, we aimed to evaluate the appropriateness of SAP use in patients undergoing surgical procedures in the field of general surgery according to the American Society of Health-System Pharmacists (ASHP) guideline and to determine the difference between the pre-training period (pre-TP) and the post-training period (post-TP) organized according to this guideline.
Methods: It is a single-center prospective study conducted in general surgery wards between January 2022 and May 2023, with 404 patients pre-TP and 406 patients post-TP.
Results: Cefazolin emerged as the predominant agent for SAP, favored in 86.8% (703/810) of cases. Appropriate cefazolin dosage increased significantly from 41% (129 patients) in pre-TP to 92.6% (276 patients) in post-TP (p < 0.001), along with a rise in adherence to recommended timing of administration from 42.2% (133 patients) to 62.8% (187 patients) (p < 0.001). The proportion of patients receiving antibiotics during hospitalization in the ward postoperatively decreased post-TP (21-14.3%; p = 0.012), as did antibiotic prescription at discharge (16.8-10.3%; p = 0.008). The incidence of SSI showed a slight increase from 9.9% in pre-TP to 13.3% in post-TP (p = 0.131).
Conclusions: Routine training sessions for surgeons emerged as crucial strategies to optimize patient care and enhance SAP compliance rates, particularly given the burden of clinical responsibilities faced by surgical teams.
(© 2024. The Author(s).)
Databáze: MEDLINE
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