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DRUGS System Enhancing Adherence of Chinese Surgeons to Antibiotic Use Guidelines during Perioperative Period

OBJECTIVE: Irrational use of antimicrobial agents for preventing postoperative SSIs is a common phenomenon in China, which results in more bacterial resistance, higher hospital infection rates, extra costs of antimicrobial agents. The aim of the study is to evaluate the effect of Drug Rational Usage...

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Autores principales: Yang, Zhifu, Zhao, Peixi, Wang, Jingwen, Tong, Liping, Cao, Jinyi, Tian, Yun, Yao, Zhanpeng, Wang, Jingbo, Zhu, Yanrong, Jia, Yanyan, Wen, Aidong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141742/
https://www.ncbi.nlm.nih.gov/pubmed/25148306
http://dx.doi.org/10.1371/journal.pone.0102226
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author Yang, Zhifu
Zhao, Peixi
Wang, Jingwen
Tong, Liping
Cao, Jinyi
Tian, Yun
Yao, Zhanpeng
Wang, Jingbo
Zhu, Yanrong
Jia, Yanyan
Wen, Aidong
author_facet Yang, Zhifu
Zhao, Peixi
Wang, Jingwen
Tong, Liping
Cao, Jinyi
Tian, Yun
Yao, Zhanpeng
Wang, Jingbo
Zhu, Yanrong
Jia, Yanyan
Wen, Aidong
author_sort Yang, Zhifu
collection PubMed
description OBJECTIVE: Irrational use of antimicrobial agents for preventing postoperative SSIs is a common phenomenon in China, which results in more bacterial resistance, higher hospital infection rates, extra costs of antimicrobial agents. The aim of the study is to evaluate the effect of Drug Rational Usage Guidelines System (DRUGS) on the surgeon's prescription behavior of antimicrobial agents. METHODS: 10 common surgical operations which included 1543 cases (where 778 cases using paper-based guidelines and 765 cases using DRUGS) were selected and their demographic and clinical data were collected. The selected operations include thyroid resection, breast mass resection, myomectomy, etc. The evaluation criteria were antibiotic administrative categories, the time of initial dose, duration of administration, length of stay, the costs of antibiotics, SSIs and drug adverse reactions(ADR). RESULTS: The antimicrobial agents were mostly administrated within 0.5 h to 2 h before incision, 656 patients (85.75%) were intervened with DRUGS and 256 (32.90%) with paper-based guidelines according to the protocol. For the clean wounds incision, 547 patients (91.62%) were within 24 h of withdrawal antibiotics with using paper-based guidelines versus 91 (14.79%) with using DRUGS. A total of 19 kinds of antibiotics were used in the 1543 cases. The leading three on the list of frequency were piperacillin and sulbactam sodium, cefathiamidine and cefoperazone. While after the intervention, the list of frequency changed to cefazolin, cefathiamidine, cefoperazone. The average hospital stay was (7.00±4.31)d with paper-based guidelines and (2.54±1.57)d with DRUGS, respectively. The average cost of antibiotics was ¥(3481.36±2584.46) with paper-based guidelines and ¥(1693.39±1478.27) with DRUGS, respectively. However, there were no significant differences in the incidence of SSIs and ADR between two groups. CONCLUSION: In this study, the increased availability of antibiotic guidelines at the time of drug ordering, combined with DRUGS, was associated with an enhanced surgeon adherence to guidelines.
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spelling pubmed-41417422014-08-25 DRUGS System Enhancing Adherence of Chinese Surgeons to Antibiotic Use Guidelines during Perioperative Period Yang, Zhifu Zhao, Peixi Wang, Jingwen Tong, Liping Cao, Jinyi Tian, Yun Yao, Zhanpeng Wang, Jingbo Zhu, Yanrong Jia, Yanyan Wen, Aidong PLoS One Research Article OBJECTIVE: Irrational use of antimicrobial agents for preventing postoperative SSIs is a common phenomenon in China, which results in more bacterial resistance, higher hospital infection rates, extra costs of antimicrobial agents. The aim of the study is to evaluate the effect of Drug Rational Usage Guidelines System (DRUGS) on the surgeon's prescription behavior of antimicrobial agents. METHODS: 10 common surgical operations which included 1543 cases (where 778 cases using paper-based guidelines and 765 cases using DRUGS) were selected and their demographic and clinical data were collected. The selected operations include thyroid resection, breast mass resection, myomectomy, etc. The evaluation criteria were antibiotic administrative categories, the time of initial dose, duration of administration, length of stay, the costs of antibiotics, SSIs and drug adverse reactions(ADR). RESULTS: The antimicrobial agents were mostly administrated within 0.5 h to 2 h before incision, 656 patients (85.75%) were intervened with DRUGS and 256 (32.90%) with paper-based guidelines according to the protocol. For the clean wounds incision, 547 patients (91.62%) were within 24 h of withdrawal antibiotics with using paper-based guidelines versus 91 (14.79%) with using DRUGS. A total of 19 kinds of antibiotics were used in the 1543 cases. The leading three on the list of frequency were piperacillin and sulbactam sodium, cefathiamidine and cefoperazone. While after the intervention, the list of frequency changed to cefazolin, cefathiamidine, cefoperazone. The average hospital stay was (7.00±4.31)d with paper-based guidelines and (2.54±1.57)d with DRUGS, respectively. The average cost of antibiotics was ¥(3481.36±2584.46) with paper-based guidelines and ¥(1693.39±1478.27) with DRUGS, respectively. However, there were no significant differences in the incidence of SSIs and ADR between two groups. CONCLUSION: In this study, the increased availability of antibiotic guidelines at the time of drug ordering, combined with DRUGS, was associated with an enhanced surgeon adherence to guidelines. Public Library of Science 2014-08-22 /pmc/articles/PMC4141742/ /pubmed/25148306 http://dx.doi.org/10.1371/journal.pone.0102226 Text en © 2014 Yang et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Yang, Zhifu
Zhao, Peixi
Wang, Jingwen
Tong, Liping
Cao, Jinyi
Tian, Yun
Yao, Zhanpeng
Wang, Jingbo
Zhu, Yanrong
Jia, Yanyan
Wen, Aidong
DRUGS System Enhancing Adherence of Chinese Surgeons to Antibiotic Use Guidelines during Perioperative Period
title DRUGS System Enhancing Adherence of Chinese Surgeons to Antibiotic Use Guidelines during Perioperative Period
title_full DRUGS System Enhancing Adherence of Chinese Surgeons to Antibiotic Use Guidelines during Perioperative Period
title_fullStr DRUGS System Enhancing Adherence of Chinese Surgeons to Antibiotic Use Guidelines during Perioperative Period
title_full_unstemmed DRUGS System Enhancing Adherence of Chinese Surgeons to Antibiotic Use Guidelines during Perioperative Period
title_short DRUGS System Enhancing Adherence of Chinese Surgeons to Antibiotic Use Guidelines during Perioperative Period
title_sort drugs system enhancing adherence of chinese surgeons to antibiotic use guidelines during perioperative period
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141742/
https://www.ncbi.nlm.nih.gov/pubmed/25148306
http://dx.doi.org/10.1371/journal.pone.0102226
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