Abstract:
Background: Surgical antimicrobial prophylaxis (SAP) is the peri-operative administration of antimicrobial agents. Compliance rates vary worldwide from 15% to 84.3%, with studies in Turkey not exceeding 35%. The aim of this multicenter study was to determine the rate of appropriate antibiotic class, timing, and duration as well as discharge prescriptions in Turkey. Thus, we aimed to determine the rate of full compliance with SAP procedures in our country Patients and Methods: This multicenter, prospective, observational, descriptive study was conducted in 47 hospitals from 28 provinces in seven different regions of Turkey. Patients over 18 years of age in all surgical units between June 6, 2022, and June 10, 2022, were included in the study. Results: Of the 7,978 patients included in the study, 332 were excluded from further analyses because of pre-existing infection, and SAP compliance analyses were performed on the remaining 7,646 cases. The antibiotic most commonly used for SAP was cefazolin (n = 4,701; 61.5%), followed by third-generation cephalosporins (n = 596; 7.8%). The most common time to start SAP was within 30 minutes before surgery (n = 2,252; 32.5%), followed by 30 to 60 minutes before surgery (n = 1,638; 23.6%). Surgical antimicrobial prophylaxis duration was <24 hours in 3,516 (50.7%) patients and prolonged until discharge in 1,505 (21.7%) patients. Finally, the actual proportion of patients compliant with SAP was 19% (n = 1,452) after omitting 4,458 (58.3%) patients who were prescribed oral antibiotic agents at discharge as part of a prolonged SAP. Conclusions: Surgical antimicrobial prophylaxis compliance rates are still very low in Turkey. Prolonged duration of SAP and especially high rate of antibiotic prescription at discharge are the main reasons for non-compliance with SAP.
摘要:
背景:外科抗菌预防(SAP)是围手术期施用抗菌药物。全球合规率从15%到84.3%不等,土耳其的研究不超过35%。这项多中心研究的目的是确定适当的抗生素类别的比率,定时,和持续时间以及土耳其的出院处方。因此,我们旨在确定我国SAP程序的完全依从性率患者和方法:这是多中心,prospective,观察,我们在土耳其7个不同地区28个省的47家医院进行了描述性研究.2022年6月6日至2022年6月10日期间所有手术单位中年龄超过18岁的患者被纳入研究。结果:在纳入研究的7,978例患者中,332人由于预先存在的感染而被排除在进一步的分析之外,对其余7,646例进行了SAP依从性分析。最常用于SAP的抗生素是头孢唑啉(n=4,701;61.5%),其次是第三代头孢菌素(n=596;7.8%)。开始SAP的最常见时间是手术前30分钟内(n=2,252;32.5%),其次是手术前30至60分钟(n=1,638;23.6%)。3,516名(50.7%)患者的手术抗菌预防持续时间<24小时,1,505名(21.7%)患者延长至出院。最后,在省略了4,458例(58.3%)患者后,符合SAP治疗的患者的实际比例为19%(n=1,452),这些患者在出院时被处方口服抗生素作为长期SAP的一部分.结论:土耳其的外科抗菌药物预防依从率仍然很低。SAP持续时间长,尤其是出院时抗生素处方率高是不符合SAP的主要原因。