Original Article

Evaluation of the Adherence to the Antimicrobial Prophylaxis Guidelines before Cardiac Surgeries in a Specialized University Hospital: A Unicenter Cross-Sectional Study from Iran

Abstract

Background: Surgical site infection (SSI) is the most common reason for patient readmission after surgery. Because most cases of surgical site infection are preventable with antimicrobial prophylaxis, adherence to appropriate guidelines is critical. The aim of this study was to evaluate adherence to guideline recommendations for antimicrobial prophylaxis of surgical site infections at Shahid Chamran Heart Hospital, Isfahan, Iran. Methods: This cross-sectional observational study was conducted using prospective data collected from December 2021 to June 2022 in the cardiac surgery ward of Chamran Hospital. Adherence to "Clinical practice guidelines for antimicrobial prophylaxis in surgery (2013)" was assessed using data from patient records regarding the type, dosage, timing, and duration of antimicrobial prophylaxis. Results: A total of 363 patients were included in this study. The compliance rate with the guideline in terms of the type, dosing, initiation time, redosing and duration of the antimicrobial agent was 99.72%, 1.6%, 98.8%, 29.28%, and 0% respectively.Conclusion: The present study revealed relatively low adherence to the guidelines in terms of dosing, re-dosing and duration of antimicrobial prophylaxis at Chamran Heart Hospital. Based on the results, developing a local guideline is highly recommended.

1. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al; Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017;152(8):784-791. Guideline for the Prevention of Surgical Site Infection, 2017.
2. Leaper DJ, Edmiston CE. World Health Organization: global guidelines for the prevention of surgical site infection. J Hosp Infect. 2017;95(2):135-136.
3. Seidelman JL, Mantyh CR, Anderson DJ. Surgical site infection prevention: A Review. JAMA. 2023;329(3):244-252.
4. Scott RD. The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention. 2009.
5. Gouvêa M, Novaes CdO, Pereira DMT, Iglesias AC. Adherence to guidelines for surgical antibiotic prophylaxis: a review. Braz J Infect Dis. 2015;19:517-24.
6. Zimlichman E, Henderson D, Tamir O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med.2013; 173:2039.
7. AlBuhairan B, Hind D, Hutchinson A. Antibiotic prophylaxis for wound infections in total joint arthroplasty: a systematic review. J Bone Joint Surg Br. 2008;90(7):915-9.
8. Tarchini G, Liau KH, Solomkin JS. Antimicrobial Stewardship in Surgery: Challenges and Opportunities. Clin Infect Dis. 2017;64(suppl_2):S112-S114.
9. Piri A, Taher A, Rahimi-bashar F, Mohammadi Y, Mehrpooya M. Assessment of antibiotic prophylaxis in surgical patients at a referral teaching hospital in western Iran. Avicenna J Pharm Res. 2022; 3(1):x-x.
10. Rafati M, Shiva A, Ahmadi A, Habibi O. Adherence to American society of health-system pharmacist’s surgical antibiotic prophylaxis guidelines in a teaching hospital. J Res Pharm Pract. 2014;3(2):62.
11. Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect (Larchmt). 2013;14(1):73-156. .
12. Al-Momany NH, Al-Bakri AG, Makahleh ZM, Wazaify MM. Adherence to international antimicrobial prophylaxis guidelines in cardiac surgery: A Jordanian study demonstrates need for quality improvement. J Manag Care Pharm. 2009;15(3):262-71.
13. Nabor MI, Buckley BS, Lapitan MC. Compliance with international guidelines on antibiotic prophylaxis for elective surgeries at a tertiary-level hospital in the Philippines. Healthcare Infection. 2015;20(4):145-51.
14. Mousavi S, Zamani E, Bahrami F. An audit of perioperative antimicrobial prophylaxis: compliance with the international guidelines. J Res Pharm Pract. 2017;6(2):126-9.
15. Zukowska A, Zukowski M. Surgical Site Infection in Cardiac Surgery. J Clin Med. 2022;11(23):6991.
Files
IssueVol 11, No 4 (Autumn 2023) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jpc.v11i4.16018
Keywords
Antimicrobial Prophylaxis; Surgical Site Infection; Cardiac Surgery
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Mirasi NS, Dianatkhah M, Hosseiny A, Soltani R, Keshavarz A, Boroumandpour S. Evaluation of the Adherence to the Antimicrobial Prophylaxis Guidelines before Cardiac Surgeries in a Specialized University Hospital: A Unicenter Cross-Sectional Study from Iran. J Pharm Care. 2023;11(4):214-218.