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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Audit of quality of perioperative antimicrobial prophylaxis

Salih Hosoglu1, Selda Aslan, Serife Akalin

  • 1Department of Clinical Microbiology and Infectious Diseases, Dicle University Hospital, 21280, Diyarbakir, Turkey. hosoglu@hotmail.com

Pharmacy World & Science : PWS
|November 27, 2008
PubMed

Insights

Perioperative antibiotic prophylaxis (PAP) prescriptions in a Turkish hospital showed high antimicrobial use density. Improved antibiotic stewardship is needed to ensure appropriate PAP use and reduce unnecessary prescriptions.

Area of Science:

  • Medical Microbiology
  • Hospital Pharmacy
  • Surgical Infections

Background:

  • Antibiotic resistance is a growing global health concern.
  • Appropriate use of perioperative antibiotic prophylaxis (PAP) is crucial for preventing surgical site infections.
  • Evaluating PAP practices is essential for optimizing antimicrobial stewardship in hospitals.

Purpose of the Study:

  • To assess the appropriateness and patterns of perioperative antibiotic prophylaxis (PAP) prescriptions.
  • To determine the density of antimicrobial use in a general hospital setting.
  • To identify areas for improvement in PAP guidelines and implementation.

Main Methods:

  • An evaluative audit of a prospective cohort was conducted between February and June 2003.
  • Data on PAP prescriptions for clean and clean-contaminated elective surgeries were collected from six surgical wards.
  • Antimicrobial use density was calculated using the Anatomical Therapeutic Chemical (ATC) - Defined Daily Dose (DDD) system per procedure.

Main Results:

  • Of 391 procedures, 331 (84.7%) received PAP.
  • PAP was indicated in 45% of the non-received group and not indicated in 15.1% of the received group.
  • Only 18.4% of PAP durations were less than 24 hours, and just 13.3% of all PAP steps were justified and correct. The most common agents were first-generation cephalosporins (85.8%) and aminoglycosides (24.2%), with inappropriate initial dose timing in 40.8% of procedures. Antimicrobial use density was high at 330.2 DDD/100-operations.

Conclusions:

  • The study revealed a very high density of antimicrobial use in perioperative antibiotic prophylaxis.
  • Significant deviations from recommended guidelines were observed regarding indication, duration, and correctness of PAP.
  • Urgent implementation of antibiotic use measurement and stewardship programs is required to improve PAP appropriateness.
Abstract

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