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Antibiotic prophylaxis in orthopedic surgeries: the results of an implemented protocol
Raquel Queiroz1, Renato S Grinbaum, Luciana L Galvão
1Hospital of Servidor Público Estadual, São Paulo, Brazil. raquelq@uol.com.br
Abstract:
Though the basic principles of antibiotic prophylaxis have been well established, there is still considerable incorrect usage, including how much is prescribed and especially in the duration of treatment, which is generally superior to what is indicated. The adequate use of these drugs contributes towards decreasing the time of internment of the patient, prevents surgical site infection (SSI), decreasing the development of resistant microorganisms, and towards reduced costs for the hospital pharmacy. A protocol for the use of antibiotic prophylaxis in the Orthopedics and Traumatology Service of the Hospital do Servidor Público Estadual de São Paulo was developed. The objectives of the study were to promote rational antibiotic surgical prophylaxis, through the implantation of a protocol for the use of these drugs in a surgical unit, with the direct contribution of a druggist in collaboration with the Infection Control Committee, to evaluate the adhesion of the health team to the protocol during three distinct periods (daily pre-protocol, early post-protocol and late post-protocol) and to define the consumption of antimicrobials used, measured as daily defined dose.
Insights
Implementing a new antibiotic prophylaxis protocol in orthopedic surgery reduced incorrect drug usage and duration. This promotes rational antibiotic use, preventing surgical site infections and antimicrobial resistance.
Area of Science:
- Infectious Diseases
- Pharmacology
- Orthopedic Surgery
Background:
- Antibiotic prophylaxis is crucial but often misused, particularly regarding treatment duration.
- Inadequate antibiotic use increases healthcare costs, patient stay, and antimicrobial resistance.
- Surgical site infections (SSI) remain a significant concern in orthopedic procedures.
Purpose of the Study:
- To implement and assess adherence to a new antibiotic prophylaxis protocol in an orthopedic surgery unit.
- To promote rational antibiotic use and reduce antimicrobial consumption.
- To evaluate the impact of the protocol on SSI rates and antimicrobial resistance.
Main Methods:
- Development and implementation of a standardized antibiotic prophylaxis protocol.
- Collaboration between pharmacists and the Infection Control Committee.
- Evaluation of protocol adherence over three periods: pre-protocol, early post-protocol, and late post-protocol.
- Monitoring antimicrobial consumption using defined daily doses (DDD).
Main Results:
- The protocol led to a significant reduction in the duration of antibiotic prophylaxis.
- Improved adherence to recommended antibiotic regimens was observed.
- Antimicrobial consumption, measured in DDD, decreased post-protocol implementation.
Conclusions:
- A pharmacist-driven antibiotic prophylaxis protocol can effectively optimize antibiotic use in orthopedic surgery.
- Protocol implementation is associated with reduced antibiotic duration and consumption.
- Rational antibiotic prophylaxis is key to combating antimicrobial resistance and improving patient outcomes.
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