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Preoperative Antibiotic Prophylaxis in Elective Minor Surgical Procedures among Adults in Southern Italy

Little is known regarding the factors associated with surgical antibiotic prophylaxis (SAP) compliance in elective minor surgery. The purposes of this cross-sectional study were to identify the frequency of inappropriate SAP administration and to understand the characteristics associated with such i...

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Autores principales: Della Polla, Giorgia, Bianco, Aida, Mazzea, Silvia, Napolitano, Francesco, Angelillo, Italo Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7603198/
https://www.ncbi.nlm.nih.gov/pubmed/33081002
http://dx.doi.org/10.3390/antibiotics9100713
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author Della Polla, Giorgia
Bianco, Aida
Mazzea, Silvia
Napolitano, Francesco
Angelillo, Italo Francesco
author_facet Della Polla, Giorgia
Bianco, Aida
Mazzea, Silvia
Napolitano, Francesco
Angelillo, Italo Francesco
author_sort Della Polla, Giorgia
collection PubMed
description Little is known regarding the factors associated with surgical antibiotic prophylaxis (SAP) compliance in elective minor surgery. The purposes of this cross-sectional study were to identify the frequency of inappropriate SAP administration and to understand the characteristics associated with such inappropriateness in a sample of elective minor surgical procedures. The study was performed between May and July 2019 among a random sample of patients aged 18 years and older in seven public hospitals randomly selected in the Campania and Calabria Regions of Italy. Globally, only 45% of SAP approaches were deemed completely in accordance with the evidence-based guidelines. Patients with an ordinary admission, those who underwent local anesthesia, those receiving plastic and reconstructive and ophthalmology surgery, and those who had not received a prosthetic implant were more likely to receive an appropriate SAP approach; those receiving obstetrics, gynecological, and urological surgical procedures were less likely than those who underwent abdominal, vascular, and breast surgery. The course of antibiotic prophylaxis was not consistent with the guidelines in 48.5% procedures with one or more reasons for inappropriateness. Appropriate time of the SAP administration was more frequently observed in patients who were older, those with a Charlson comorbidity index of 0, those who did not receive a prosthetic implant, and those receiving plastic and reconstructive surgery; it was less likely in patients receiving obstetrics, gynecological, and urological surgeries compared with those who underwent abdominal, vascular, and breast surgery. Aspects of SAP that need to be improved are molecule choice, time of administration, and specific surgical procedures. Hospital managers should involve surgeons and anesthesiologists in initiatives tailored to optimize SAP prescribing.
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spelling pubmed-76031982020-11-01 Preoperative Antibiotic Prophylaxis in Elective Minor Surgical Procedures among Adults in Southern Italy Della Polla, Giorgia Bianco, Aida Mazzea, Silvia Napolitano, Francesco Angelillo, Italo Francesco Antibiotics (Basel) Article Little is known regarding the factors associated with surgical antibiotic prophylaxis (SAP) compliance in elective minor surgery. The purposes of this cross-sectional study were to identify the frequency of inappropriate SAP administration and to understand the characteristics associated with such inappropriateness in a sample of elective minor surgical procedures. The study was performed between May and July 2019 among a random sample of patients aged 18 years and older in seven public hospitals randomly selected in the Campania and Calabria Regions of Italy. Globally, only 45% of SAP approaches were deemed completely in accordance with the evidence-based guidelines. Patients with an ordinary admission, those who underwent local anesthesia, those receiving plastic and reconstructive and ophthalmology surgery, and those who had not received a prosthetic implant were more likely to receive an appropriate SAP approach; those receiving obstetrics, gynecological, and urological surgical procedures were less likely than those who underwent abdominal, vascular, and breast surgery. The course of antibiotic prophylaxis was not consistent with the guidelines in 48.5% procedures with one or more reasons for inappropriateness. Appropriate time of the SAP administration was more frequently observed in patients who were older, those with a Charlson comorbidity index of 0, those who did not receive a prosthetic implant, and those receiving plastic and reconstructive surgery; it was less likely in patients receiving obstetrics, gynecological, and urological surgeries compared with those who underwent abdominal, vascular, and breast surgery. Aspects of SAP that need to be improved are molecule choice, time of administration, and specific surgical procedures. Hospital managers should involve surgeons and anesthesiologists in initiatives tailored to optimize SAP prescribing. MDPI 2020-10-18 /pmc/articles/PMC7603198/ /pubmed/33081002 http://dx.doi.org/10.3390/antibiotics9100713 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Della Polla, Giorgia
Bianco, Aida
Mazzea, Silvia
Napolitano, Francesco
Angelillo, Italo Francesco
Preoperative Antibiotic Prophylaxis in Elective Minor Surgical Procedures among Adults in Southern Italy
title Preoperative Antibiotic Prophylaxis in Elective Minor Surgical Procedures among Adults in Southern Italy
title_full Preoperative Antibiotic Prophylaxis in Elective Minor Surgical Procedures among Adults in Southern Italy
title_fullStr Preoperative Antibiotic Prophylaxis in Elective Minor Surgical Procedures among Adults in Southern Italy
title_full_unstemmed Preoperative Antibiotic Prophylaxis in Elective Minor Surgical Procedures among Adults in Southern Italy
title_short Preoperative Antibiotic Prophylaxis in Elective Minor Surgical Procedures among Adults in Southern Italy
title_sort preoperative antibiotic prophylaxis in elective minor surgical procedures among adults in southern italy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7603198/
https://www.ncbi.nlm.nih.gov/pubmed/33081002
http://dx.doi.org/10.3390/antibiotics9100713
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