A new antibiotic stewardship program approach is effective on inappropriate surgical prophylaxis and discharge prescription

  • Cem Karaali Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey
  • Mustafa Emiroglu Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey
  • Sabri Atalay Department of Infectious Diseases, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey
  • Ismail Sert Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey
  • Ayberk Dursun Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey
  • Sukran Kose Department of Infectious Diseases, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey
  • Gokhan Akbulut Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey
  • Cengiz Aydın Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey
Keywords: antibiotic stewardship program, general surgery, discharge prescription, surgical antibiotic prophylaxis

Abstract

Introduction: This study aims to evaluate the efficacy of a new antimicrobial stewardship program (ASP) on surgical antibiotic prophylaxis (SP) and antibiotics in discharge prescriptions used as a continuation of SP.

Methodology: The study included elective patients with clean and clean-contaminated wounds. The accuracy of the assigned SP was evaluated according to international guidelines. Primary outcome measures comprised appropriateness of prophylactic antibiotic indication, correct timing of initial dose, discontinuation of SP within 24 hours, and antibiotic prescription at discharge. A secondary outcome measure was to determine whether the effect of ASP was sustained long-term.

Results: The total compliance rate for all stages of SP increased from 8% to 52.1% after the intervention (p < 0.05). When analyzed according to individual SP components, it was found that although ASP did not change first dose timing rates, it did affect the rates of prophylactic antibiotic indication, discontinuation of SP within 24 hours and antibiotic prescription at discharge, with statistical significance (p < 0.05). In addition, ASP continued to increase its effectiveness throughout the 3rd year.

Conclusions: Based on the findings of our study, it seems clear that the modified ASP introduced in our general surgery clinic can be used effectively and simply; in addition, this ASP increases its efficacy with time.

Author Biographies

Mustafa Emiroglu, Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey

Genel Cerrahi Doçenti, Hastane CEO'su

Sabri Atalay, Department of Infectious Diseases, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey

Associate Professor of Infectious Diseases 

Ismail Sert, Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey

Associate Professor of general surgery and head of transplant surgery

Ayberk Dursun, Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey

general surgery assistant

Sukran Kose, Department of Infectious Diseases, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey

Professor of Infectious Diseases, head of the Infectious Diseases clinic

Gokhan Akbulut, Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey

former CEO of the hospital, Prof of Surgery

Cengiz Aydın, Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey

Prof of Surgery, Clinic director of the general surgery clinic

Published
2019-11-30
How to Cite
1.
Karaali C, Emiroglu M, Atalay S, Sert I, Dursun A, Kose S, Akbulut G, Aydın C (2019) A new antibiotic stewardship program approach is effective on inappropriate surgical prophylaxis and discharge prescription. J Infect Dev Ctries 13:961-967. doi: 10.3855/jidc.11734
Section
Original Articles