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Updated: Jul 7, 2026
11:17
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Ensuring appropriate timing of antimicrobial prophylaxis.
Andrew D Rosenberg1, Daniel Wambold, Linede Kraemer
1NYU Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003, USA. Andrew.Rosenberg@med.nyu.edu
The Journal of Bone and Joint Surgery. American Volume
|February 5, 2008
Summary
Implementing a surgical "time-out" checklist significantly improved adherence to the one-hour window for intravenous antibiotic prophylaxis before surgery. This simple, cost-free method enhanced patient safety by reducing surgical site infection risk.
Area of Science:
- Surgical Safety Protocols
- Infection Prevention
- Healthcare Quality Improvement
Background:
- Intravenous antibiotic prophylaxis within one hour of surgical incision is crucial for reducing surgical site infections.
- Established methods for ensuring compliance with antibiotic timing protocols are lacking.
- Surgical site infections (SSIs) remain a significant concern in healthcare settings.
Purpose of the Study:
- To evaluate the effectiveness of integrating antibiotic prophylaxis timing verification into an existing surgical "time-out" protocol.
- To assess compliance rates before, during, and after the implementation of the integrated safety initiative.
- To determine if this method improves adherence to the recommended antibiotic administration window.
Main Methods:
- A seven-week study period where antibiotic prophylaxis timing was added to the "time-out" checklist for spine, total hip, and total knee arthroplasty surgeries.
- Comparison of compliance rates during the study period with a three-month pre-protocol period and an eighteen-month post-protocol period.
- Utilized independent audits to verify sustained compliance.
Main Results:
- The integrated protocol achieved 99.1% compliance with antibiotic administration within the optimal timeframe.
- Baseline compliance was 65%, significantly increasing to 99.1% during the study (p < 0.0001).
- Sustained compliance of 97% was observed 18 months post-implementation, with independent audits confirming ongoing effectiveness.
Conclusions:
- Integrating antibiotic prophylaxis verification into the wrong-site-surgery "time-out" is an effective strategy.
- This method is cost-free and easily adoptable by healthcare institutions.
- The protocol significantly enhances compliance with prophylactic antibiotic timing, contributing to patient safety.
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