Compliance with antibiotic prophylaxis guidelines in surgery: Results of a targeted audit in a large-scale region-based French hospital network.
Amoxicillin-Potassium Clavulanate Combination
/ administration & dosage
Anti-Bacterial Agents
/ administration & dosage
Antibiotic Prophylaxis
/ methods
Appendectomy
/ methods
Arthroplasty, Replacement, Hip
/ methods
Cesarean Section
/ methods
Clinical Audit
Female
Guideline Adherence
/ statistics & numerical data
Hospitals
Humans
Male
Practice Guidelines as Topic
Pregnancy
Retrospective Studies
Surgical Procedures, Operative
/ methods
Surgical Wound Infection
/ drug therapy
Transurethral Resection of Prostate
/ methods
Antibiotic prophylaxis/statistics & numerical data
Clinical audit
Guideline adherence
Surgical Wound/Surgical site Infection/prevention & control*
Journal
Infectious diseases now
ISSN: 2666-9919
Titre abrégé: Infect Dis Now
Pays: France
ID NLM: 101775152
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
10
06
2019
revised:
20
12
2019
accepted:
07
10
2020
pubmed:
18
10
2020
medline:
15
9
2021
entrez:
17
10
2020
Statut:
ppublish
Résumé
While regional monitoring of antibiotic use has decreased since 2011 by 3.2%, in some healthcare facilities a significant increase (+43%) has occurred. The purpose of this study was to assess regional antibiotic prophylaxis (ABP) compliance with national guidelines. In 2015, 26 healthcare facilities, both public and private, were requested to audit five items: utilization of antibiotic prophylaxis, the antimicrobial agent (the molecule) administered, time between injection and incision, initial dose, number of intraoperative and postoperative additional doses. Seven surgical procedures were selected for assessment: appendicectomy (APP), cataract (CAT), cesarean section (CES), colorectal cancer surgery (CCR), hysterectomy (HYS), total hip arthroplasty (THA) and transurethral resection of the prostate (TURP). A statistical analysis of the 2303 records included was carried out. The general rate of antibiotic prophylaxis compliance was 64%. The antimicrobial agent used and initial dose were in compliance with the guidelines for 93% and 97.4% of cases respectively, and administration of antibiotic prophylaxis was achieved 60minutes before incision in 77.6% of the records included. Regarding gastrointestinal surgery, amoxicillin/clavulanic acid was used in 32% of patients. In 26% of appendectomy files, administration occurred after incision, and one out of two files showed non-complaint perioperative and postoperative consumption. Compliance with nationwide ABP guidelines is in need of pronounced improvement, especially with regard to time interval between injection and incision and the molecule prescribed. An action plan based on specific recommendations addressed to each establishment and an updated regionwide ABP protocol are aimed at achieving better and reduced consumption of antimicrobial agents.
Identifiants
pubmed: 33068683
pii: S0399-077X(20)30732-0
doi: 10.1016/j.medmal.2020.10.005
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Amoxicillin-Potassium Clavulanate Combination
74469-00-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
170-178Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.