title: Successful implementation of a window for routine antimicrobial prophylaxis shorter than that of the World Health Organization standard.
abstract: OBJECTIVE
  To evaluate the feasibility of implementation of the refined window for routine antimicrobial prophylaxis (RAP) of 30-74 minutes before skin incision compared to the World Health Organization (WHO) standard of 0-60 minutes.
  
  
  METHODS
  Prospective study on timing of routine antimicrobial prophylaxis in 2 different time periods.
  
  
  METHODS
  Tertiary referral university hospital with 30,000 surgical procedures per year.
  
  
  METHODS
  In all consecutive vascular, visceral, and trauma procedures, the timing was prospectively recorded during a first time period of 2 years (A; baseline) and a second period of 1 year (B; after intervention). An intensive intervention program was initiated after baseline. The primary outcome parameter was timing; the secondary outcome parameter was surgical site infection (SSI) rate in the subgroup of patients undergoing cholecystectomy/colon resection.
  
  
  RESULTS
  During baseline time period A (3,836 procedures), RAP was administered 30-74 minutes before skin incision in 1,750 (41.0%) procedures; during time period B (1,537 procedures), it was administered in 914 (56.0%; [Formula: see text]). The subgroup analysis did not reveal a significant difference in SSI rate.
  
  
  CONCLUSIONS
  This bundle of interventions resulted in a statistically significant improvement of timing of RAP even at a shortened window compared to the WHO standard.
authors.affiliation: Division of General Surgery, University Hospital of Basel, Basel, Switzerland. mistelih@uhbs.ch
authors.forename: Heidi
authors.initials: H
authors.lastname: Misteli
authors.forename: Andreas F
authors.initials: AF
authors.lastname: Widmer
authors.forename: Walter P
authors.initials: WP
authors.lastname: Weber
authors.forename: Evelyne
authors.initials: E
authors.lastname: Bucher
authors.forename: Marc
authors.initials: M
authors.lastname: Dangel
authors.forename: Stefan
authors.initials: S
authors.lastname: Reck
authors.forename: Daniel
authors.initials: D
authors.lastname: Oertli
authors.forename: Walter R
authors.initials: WR
authors.lastname: Marti
authors.forename: Rachel
authors.initials: R
authors.lastname: Rosenthal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods* / Q000592:standards; D002511:Cephalosporins / Q000008:administration & dosage* / Q000627:therapeutic use; D002763:Cholecystectomy; D015331:Cohort Studies; D003082:Colectomy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome; D014944:World Health Organization
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins