Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06230, Ankara, Turkey.
Department of General Surgery, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey.
Eur J Med Res. 2024 Jun 19;29(1):340. doi: 10.1186/s40001-024-01938-w.
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.
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.
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).
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.
手术部位感染（SSI）的特征是术后在手术切口、器官或体腔部位发生感染。遵守外科抗菌预防（SAP）对于减轻 SSI 的发生至关重要。在这项研究中，我们旨在根据美国卫生系统药剂师协会（ASHP）指南评估普外科手术患者 SAP 使用的适当性，并确定根据该指南组织的培训前时期（pre-TP）和培训后时期（post-TP）之间的差异。
这是一项单中心前瞻性研究，于 2022 年 1 月至 2023 年 5 月在普外科病房进行，pre-TP 期有 404 例患者，post-TP 期有 406 例患者。
头孢唑林是 SAP 的主要药物，在 86.8%（703/810）的情况下被选用。适当的头孢唑林剂量从 pre-TP 的 41%（129 例）显著增加到 post-TP 的 92.6%（276 例）（p<0.001），同时推荐的给药时间的依从性从 42.2%（133 例）增加到 62.8%（187 例）（p<0.001）。术后住院期间在病房接受抗生素治疗的患者比例在 post-TP 期有所下降（21-14.3%；p=0.012），出院时开具抗生素处方的比例也有所下降（16.8-10.3%；p=0.008）。SSI 的发生率从 pre-TP 的 9.9%略有增加到 post-TP 的 13.3%（p=0.131）。
定期为外科医生举办培训课程是优化患者护理和提高 SAP 依从率的关键策略，特别是考虑到外科团队面临的临床责任负担。
