Successful implementation of a window for routine antimicrobial prophylaxis shorter than that of the World Health Organization standard

Infect Control Hosp Epidemiol. 2012 Sep;33(9):912-6. doi: 10.1086/667374. Epub 2012 Jul 24.

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.

Design: Prospective study on timing of routine antimicrobial prophylaxis in 2 different time periods.

Setting: 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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis / methods*
  • Antibiotic Prophylaxis / standards
  • Cephalosporins / administration & dosage*
  • Cephalosporins / therapeutic use
  • Cholecystectomy
  • Cohort Studies
  • Colectomy
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Preoperative Care / methods*
  • Preoperative Care / standards
  • Prospective Studies
  • Surgical Wound Infection / prevention & control*
  • Time Factors
  • Treatment Outcome
  • World Health Organization

Substances

  • Anti-Bacterial Agents
  • Cephalosporins