Prevention of surgical site infection via antibiotic administration according to guidelines after gynecological surgery
| Autor: | Yoko Nukui, Mutsuko Moriwaki, Mari Shima, Mikayo Toba, Kiyohide Fushimi, Noriko Oshima, Satoshi Obayashi, Yoshibumi Aiso |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Hysterectomy business.industry medicine.drug_class Incidence (epidemiology) medicine.medical_treatment Antibiotics Obstetrics and Gynecology Discontinuation 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine medicine Lymphadenectomy 030212 general & internal medicine Dosing Antibiotic prophylaxis business Gynecological surgery |
| Zdroj: | Journal of Obstetrics and Gynaecology Research. 44:1800-1807 |
| ISSN: | 1341-8076 |
| Popis: | Aim We modified the antimicrobial prophylaxis of surgical site infection (SSI) according to the guidelines of the Japanese Society of Chemotherapy and Japan Society of Infectious Diseases (hereinafter referred to as optimization) and measured outcomes. Methods From April 2016 to March 2017, we performed cesarean section and open hysterectomy with optimization, and compared the outcome to that of surgery performed without optimization between April 2014 and March 2016. We measured the rates of antibiotic discontinuation, appropriate antibiotic selection, SSI incidence, resumption of antibiotic therapy and fever incidence, as well as the length of postoperative hospital stay and medical expenses for antibiotics to evaluate the appropriateness and outcomes of antibiotic prophylaxis. Results Optimization resulted in a change in the method of selecting antibiotics for cesarean section, but there was no change in SSI incidence rate (0.74% vs 0.0%, P = 0.36). Optimization reduced the use of antibiotics and medical expenses of hysterectomy (median reduction of 50% and 78% for hysterectomy without or with lymphadenectomy, respectively). However, there was no change in outcome regarding SSI incidence (5.7% vs 0.0%, P = 0.11 and 7.8% vs 9.5%, P = 0.77, respectively). Conclusion Appropriate use of antibiotics according to guidelines reduced antibiotic dose and medical expenses, but there was no change in outcome regarding SSI incidence rate. These findings suggested that implementation of dosing regimens according to the guidelines would be useful to reduce antibiotic medicine costs and prevent resistant bacteria and complications associated with antibiotics. |
| Databáze: | OpenAIRE |
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