Analysis on the transition of change in antimicrobical use following preventive intervention in the perioperative antimicrobial prophylaxis in a hospital

Abstract number: R2355

Kim J.Y., Yoon Y.K., Park D.W., Kim Y.M., Kim M.J.

Objectives: To confirm short-term effects of intervention in perioperative antimicrobial prophylaxis using computed prescription system

Methods: This was a prospective, before-after comparative study of the intervention conducted at an 860-bed university hospital in Korea, from January 2007 through September 2007. Computed intervention programme has been executed for the appropriate perioperative prophylactic antimicrobial use from May 2007. Upon antimicrobial prescription, computed intervention programme displayed pop-up providing recommended guidelines on the appropriate duration and type of antimicrobials and required to check the reason for prescribing. A small working group monitored the perioperative prophylactic antimicrobial use by department, division and class every two weeks and gave feedback to the departments and surgical doctors. The effect of intervention programme was analysed in comparing antimicrobial use density (AUD) in September 2007 with AUD in January 2007 (pre-intervention period) and the average AUD of last year. The transition of change in the usage of antimicrobials on overall and surgical purpose was analysed in detail, by monthly doses and antimicrobial class.

Result: Average monthly AUD for surgical patients (surgical AUD, 715) was higher than overall AUD, 516 in 2006. After intervention programme, surgical AUD dropped 23.0%, from 695 in January to 536 in September 2007. Likewise, overall AUD went down 8.8% from 503 to 459. Due to changes in doses by antimicrobial class, surgical AUD for 3rd generation cephalosporin decreased 53.3%, from 187 of annual average in 2006 to 87 in September 2007 and reduced 44.4%, from 157 in January to 87 in September 2007. For aminoglycoside class, surgical AUD fell 44.2%, from 211 of annual average in 2006 to 118 in September 2007, and diminished 48.5%, from 229 in January to 118 in September 2007. This shows that antimicrobials in these two classes have led the changes in overall antimicrobial use. Meanwhile, 2nd generation cephalosporin relatively increased 10.8% and 5.9% in the same comparison as above.

Conclusion: Regarding the transition of change in antimicrobial use before and after computed intervention programme, 3rd generation cephalosporin and aminoglycoside classes use in surgical patients were remarkably reduced, which attributed to the decrease in overall antimicrobial use.