Appropriate perioperative antibiotic prophylaxis: challenges, strategies, and quality indicators.
BACKGROUND
Surgical site infections (SSIs) are common surgical complications and perioperative antibiotic prophylaxis (PAP) contributes to the reduction of the associated risk. The aim of the present review article is to summarize the most recently published studies with a special focus on challenges, strategies and quality indicators of PAP.


METHODS
Literature searches in the Medline database, using PubMed, were carried out for studies published from January 2011 to April 2015. Inclusion criteria were all types of epidemiological studies investigating: i. compliance with PAP recommendations at different levels by using process indicators, and ii. the effect of different interventions conducted in order to improve PAP compliance.


RESULTS
A total of 28 studies were retrieved. Overall compliance with all included PAP indicators ranged from 9.4% to 80%. Generally, compliance with the PAP process indicators significantly improved after interventions.


CONCLUSIONS
The present review summarizes the recent published studies and indicates an overall inadequate compliance with PAP recommendations, underlining the need to develop and to implement successful strategies to improve adherence to guidelines. Different interventions were found efficacious in order to increase compliance with appropriate PAP administration.
Dip. Scienze mediche, chirurgiche e tecnologie avanzate "G.F. Ingrassia", Università di Catania, Italy.
Antonella
A
Agodi
Dip. Scienze mediche, chirurgiche e tecnologie avanzate "G.F. Ingrassia", Università di Catania, Italy.
Martina
M
Barchitta
Dip. Scienze mediche, chirurgiche e tecnologie avanzate "G.F. Ingrassia", Università di Catania, Italy.
Andrea
A
Maugeri
Azienda ospedaliera "San Camillo-Forlanini", Roma, Italy.
Luisa
L
Sodano
Dip. Scienze biomediche, biotecnologiche e traslazionali, Università di Parma, Italy. ira.pasquarella@unipr.it.|Coordinator of the GISIO WG.
Cesira
C
Pasquarella
D019072:Antibiotic Prophylaxis / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D002985:Clinical Protocols; D015331:Cohort Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data / Q000639:trends; D006282:Health Personnel / Q000193:education; D006801:Humans; D019990:Perioperative Care / Q000379:methods* / Q000592:standards; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013664:Teaching Materials