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Maruxa Hernández Corredoira
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Manuela Velázquez Prieto
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Volume 23 - Issue 4, October-December 2021
ORIGINAL
ANTIMICROBIAL-STEWARDSHIP INTERVENTIONS IN THE CONTEXT OF ANTIBIOTICS PROPHYLAXIS IN GENERAL SURGERY: EVALUATION OF PROCEDURES AND OUTCOMES
BUSA GIULIA, DACOMO ALESSANDRO, DE MARCHI FRANCESCO, CHIMETTO ANDREA, RASSU MARIO, BRAGAGNOLO LUCIANA


Background: Surgical site infections (SSI) represent the most common healthcare-associated infections (HAI), with a negative impact in terms of morbidity and mortality.The literature reports preventable SSI rates over 65%. Approximately 30-50% of antimicrobials used in hospitals are for surgical prophylaxis but 30-90% of them
are used inappropriately. The promotion of the responsible use of antibiotics through antimicrobial-stewardship programs, as well as the evaluation of the effectiveness of such interventions is fundamental.

Method: In 2017, a hospital multidisciplinary team drafted and shared local evidence based recommendations about antibiotic prophylaxis (AP) in surgery departments. In addition, the Hospital Infection Committee (HIC) promoted and verified the application of the guidelines (GL) in clinical practice. In 2018, the hospital pharmacy
in collaboration with General Surgery Division, promoted an observational study to verify the GL adherence. From January to December 2018, 1,661 general surgery procedures were evaluated. The optimal use of AP included the following dimensions: selection of the agent, timing, doses and duration of administration of AP.

Results: The AP adherence was 86%. Then an analysis of the outcome was carried out. The rate of surgical site infections was 8%. The practice allowed identifying the procedures most associated with post-surgical infections and the main responsible bacteria. It was also noted that the duration of hospitalization was higher when there was not AP adherence. It was also examined whether inappropriate prophylaxis exposed to such infections. The hypothesis has been confirmed.

Conclusions: The results were discussed with the involved health professionals to promote greater GL adherence.

ANTIMICROBIAL STEWARDSHIP – CLINICAL PRACTICE – GUIDELINES – PERIOPERATIVE ANTIMICROBIAL PROPHYLAXIS – SURGICAL SITE INFECTION




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