title: Perioperative antibiotic prophylaxis: improved compliance and impact on infection rates.
abstract: The aims of this study were to determine adherence to the perioperative antibiotic prophylaxis (PAP) protocol used at a large Italian teaching hospital during a 6-year period, to assess the variables associated with inappropriate administration, and to measure the impact on surgical site infection (SSI) rates. There were 28 621 patients surveyed of which 74·6% received PAP. An improvement in adherence to the PAP protocol was registered for 58·8% of patients. Significant risk factors were an American Society of Anesthesiologists (ASA) score ≥ 2 [odds ratios (OR) from 1·28 (95% confidence interval (CI) 1·19-1·37) to 1·87 (95% CI 1·43-2·44)], prolonged duration of surgery (OR 1·68, 95% CI 1·56-1·82) and urgent surgery (OR 2·16, 95% CI 1·96-2·37). During the study period, a significant reduction in SSIs rates was detected. We concluded that the global reduction of inadequate PAP administration signifies the efficacy of a multidisciplinary quality improvement initiative on antimicrobial utilization, and this is supported by the observed reduction of the SSI rate.
authors.affiliation: Department of Biomedical Sciences, Section of Hygiene, Public Health and Preventive Medicine, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Prospero
authors.forename: P
authors.initials: P
authors.lastname: Barbadoro
authors.forename: A
authors.initials: A
authors.lastname: Marigliano
authors.forename: E
authors.initials: E
authors.lastname: Martini
authors.forename: M M
authors.initials: MM
authors.lastname: D'Errico
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017053:Infection Control; D008297:Male; D019990:Perioperative Care; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents