Background
A prospective multicenter survey was conducted to assess the rational use of antibiotics
in clean and clean-contaminated elective surgical procedures applied in 53 grade III
first class hospitals in Shandong Province, China, from 2006 to 2011. The survey was
designed to examine the prevalence of antibiotic prophylaxis, evaluate the quality
of perioperative antibiotic prophylaxis (PAP) prescriptions, and investigate the risk
factors associated with inappropriate indication for antibiotic prophylaxis.
Methods
Medication charts and medical, anesthetic, and nursing records were reviewed. Antibiotic
prescriptions were compared with the Chinese National Antibiotic Guideline on indication,
antibiotic combination, antibiotic choice, dose, dosing interval, route of administration,
timing of first administration, and duration of prophylaxis.
Results
14,261 of 14,525 procedures (98.2%) receiving antibiotic prophylaxis. The most frequently
encountered noncompliance types were PAP indications (18.6%), duration of prophylaxis
(26.7%), and timing of first administration (30.3%). The steps of PAP were justified
and correct only in 9.4% of procedures. Risk factors independently associated with
inappropriate indication for antibiotic prophylaxis were seen in age, hospital type,
hospital size, surgical disciplines, and surgical duration.
Conclusion
Results showed a significantly high rate of antibiotic prophylaxis in clean and clean-contaminated
elective surgery and also a high prevalence of inappropriate indication prescriptions.
These findings suggest important areas for intervention and implementation of antibiotic
stewardship policies in Shandong Province hospitals.
Key Words
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Article info
Publication history
Published online: March 24, 2014
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
