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Results after the introduction of a pharmacist-managed surgical antibiotic use policy

Abstract number: P1282

Szabo M., Abraham S., Benko R., Matuz M., Hajdu E., Lazar G.

Objectives: Our study aims at comparing the use of surgical antibiotics before and after the introduction of local surgical antibiotic use policy.

Methods: The research was performed at an 82-bed General Surgery Department. The local surgical antibiotic use policy was launched by the pharmacy service in December 2005. We analysed the surgery-related antibiotic use in the February months the preceding (2004–2005: Period I) and in the subsequent two years (2006–2007: Period II). In order to determine individual antibiotic usage, data were collected retrospectively from flow-charts and anaesthetic records. Surgical procedures were classified according to wound class categories. The following parameters were compared: the frequency of antibiotic use in different wound class categories, the timing of antibiotic administration, the duration and the average price of antibiotic use.

Results: 822 operations were performed (438 in period I; 384 in period II). In terms of wound class, antibiotics were administered in the following proportions: 30.3% vs. 44.8% clean, 54.2% vs. 50.0% clean-contaminated, 41.3% vs. 60.3% contaminated, and 86.2% vs. 83.3% infected surgeries. The most frequently used antibiotics was cefuroxime (or cefuroxime-metronidazole combination) in both periods. Concerning proper timing, Period I saw antibiotics administered in the morning, disregarding whether the patient was operated immediately afterwards or only later during the day. In period II antibiotics were administered in the operating theatre in all instances, concurrently with the induction of anaesthesia. The average duration of the surgery-related antibiotic use was 3.3±2.0 days in period I, vs. 2.4±2.0 days in period II. Calculating with prices valid in 2007, the average price of surgery-related antibiotic use has decreased from 18.3±5 to 9.0±2 Euro.

Conclusion: The introduction of the local surgery-related antibiotic use policy was successful in several aspects, since proper timing, shorter duration of prophylactic antibiotic use and cost savings were achieved. However, patient-level analysis highlighted fields of inappropriateness: despite the fact that prophylactic or therapeutic antibiotic use would be in several cases the surgeons did not indicate antibiotic use. Therefore, we demonstrated that the initiations of the pharmacy service and the continuous evaluation of its effectiveness are both essential in order to improve surgery-related antibiotic use.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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