Puntos críticos para implementar un formulario de antibióticos para el manejo de infección de herida quirúrgica

BACKGROUND: Surgical site infection (SSI) is a major complication of surgical procedures and contributes to morbidity, mortality, and healthcare costs. It is commonly caused by Gram-negative bacteria and should be monitored in hospital units. OBJECTIVE: To identify critical points to implement an antibiotic form for surgical wound infection management. MATERIAL AND METHODS: Descriptive observational study in 100 cultures of wounds with SSI. The most common diagnosis, the microorganism involved, sensitivity to antibiotics and prescription consistency were identified. In addition, demographic variables were assessed and a questionnaire was applied to surgeons in order to identify the critical points to implement a local formulary of antibiotics. RESULTS: 37% of cultures came from female patients. The most common diagnosis was hollow viscus perforation in 31%. The most common microorganism was Escherichia coli ESBL in 20% and 55% of these were sensitive to imipenem. The critical points observed were consistency in the prescription of antimicrobials, which reached only 29%, and that surgeons did not actively participate in strategies for the rational use of antibiotics. CONCLUSIONS: As a critical point to implement the antibiotic form, little involvement of surgeons with the hospital infection control team was found. The incidence of SSI was 2.4%, predominantly in emergency surgery. The presence of E. coli ESBL is frequent, with resistance to broad-spectrum antimicrobials.