PDF(Pubmed)
Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
摘要：
背景：手术部位感染（SSI）的特征是发生在手术切口部位的感染，器官或腔在术后期间。坚持外科抗菌药物预防（SAP）对于减轻SSIs的发生至关重要。在这项研究中,我们的目的是根据美国卫生系统药剂师协会(ASHP)指南,评估在普外科领域接受外科手术的患者中使用SAP的适当性,并确定培训前(TP前)和根据该指南组织的培训后(TP后)之间的差异.
方法：这是2022年1月至2023年5月在普外科病房进行的一项单中心前瞻性研究，TP前患者404例，TP后患者406例。
结果：头孢唑林成为SAP的主要药物，在86.8%(703/810)的病例中受益。适当的头孢唑啉剂量从TP前的41％（129例）显着增加到TP后的92.6％（276例）（p<0.001），同时,患者对推荐给药时间的依从性从42.2%(133例)上升至62.8%(187例)(p<0.001).住院期间接受抗生素治疗的患者比例在术后TP降低(21-14.3%;p=0.012),出院时的抗生素处方也是如此（16.8-10.3％；p=0.008）。SSI的发生率从TP前的9.9％略微增加到TP后的13.3％（p=0.131）。
结论：外科医生的常规培训课程成为优化患者护理和提高SAP依从率的重要策略。特别是考虑到外科团队面临的临床责任负担。
方法：这是2022年1月至2023年5月在普外科病房进行的一项单中心前瞻性研究，TP前患者404例，TP后患者406例。
结果：头孢唑林成为SAP的主要药物，在86.8%(703/810)的病例中受益。适当的头孢唑啉剂量从TP前的41％（129例）显着增加到TP后的92.6％（276例）（p<0.001），同时,患者对推荐给药时间的依从性从42.2%(133例)上升至62.8%(187例)(p<0.001).住院期间接受抗生素治疗的患者比例在术后TP降低(21-14.3%;p=0.012),出院时的抗生素处方也是如此（16.8-10.3％；p=0.008）。SSI的发生率从TP前的9.9％略微增加到TP后的13.3％（p=0.131）。
结论：外科医生的常规培训课程成为优化患者护理和提高SAP依从率的重要策略。特别是考虑到外科团队面临的临床责任负担。
