title: Appropriateness of surgical antibiotic prophylaxis for breast surgery procedures.
abstract: Background Guidelines for the appropriate use of antibiotic prophylaxis are provided in the Therapeutic Guidelines: Antibiotics (eTG) in Australia. Inappropriate use of antibiotics is problematic. Objective To examine adherence with therapeutic guidelines (eTG) in breast surgery and trends in non-adherence dependent on the type of breast surgery performed. Setting Major Western Australian teaching hospital. Method A retrospective cross-sectional study reviewed a random sample of 150 from 1049 eligible medical records of patients who underwent a breast surgical procedure in 2013 or 2014. Main outcome measure Adherence to the eTG. Results Antibiotic prophylaxis was prescribed for 139 (92.7%) operations. Adherence to the eTG occurred in 20 (13.3%) operations, whilst 11 (7.3%) did not adhere to any element of the eTG. Appropriate timing was the main factor not adhered to. Postoperative antibiotics were prescribed following 35 (23.3%) operations, with 32 (91.4%) administered beyond 24 h. Length of stay was significantly different (p = 0.0036) between surgical groups. There was a tendency for risk of an infection to be decreased with adherence (odds ratio: 0.23; 95% CI: 0.05, 1.07; p = 0.06). Conclusion Adherence to the eTG was low (13.3%), despite a decreased risk of SSI when guidelines were followed.
authors.affiliation: Curtin University, Bentley, WA, Australia.
authors.forename: Smeem
authors.initials: S
authors.lastname: Jaber
authors.affiliation: Curtin University, Bentley, WA, Australia.
authors.forename: Crystal
authors.initials: C
authors.lastname: Rogers
authors.affiliation: Curtin University, Bentley, WA, Australia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Sunderland
authors.affiliation: Curtin University, Bentley, WA, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Parsons
authors.affiliation: Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: MacKenzie
authors.affiliation: Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
authors.forename: Jason
authors.initials: J
authors.lastname: Seet
authors.affiliation: Curtin University, Bentley, WA, Australia. P.Czarniak@curtin.edu.au.
authors.forename: Petra
authors.identifier: http://orcid.org/0000-0001-7212-0667
authors.initials: P
authors.lastname: Czarniak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D001315:Australia; D001940:Breast / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D055815:Young Adult
keywords: Adherence; Antibiotic prophylaxis; Australia; Breast surgery; Clinical guidelines