[Association between prophylactic antibiotic use and surgical site infection based on quality assessment data in Korea].
OBJECTIVE
To examine the prophylactic antibiotic use in reducing surgical site infection.


METHODS
This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates.


RESULTS
The study population consisted of 16, 348 patients (1,588 gastrectomies, 2,327 cholecystectomies, 1,384 colectomies, 3,977 hysterectomies and 7,072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy.


CONCLUSIONS
This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.
Health Insurance Review & Assessment Service, Korea.
Kyoung Hoon
KH
Kim
Choon Seon
CS
Park
Jin Hee
JH
Chang
Nam Soon
NS
Kim
Jin Seo
JS
Lee
Bo Ram
BR
Choi
Byung Ran
BR
Lee
Kyoo Duck
KD
Lee
Sun Min
SM
Kim
Seon A
SA
Yeom
D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D019984:Quality Indicators, Health Care; D056910:Republic of Korea; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D055815:Young Adult