Improving compliance with surgical antibiotic prophylaxis guidelines: A multicenter evaluation

Area of Science:

• Infectious Diseases
• Surgical Outcomes
• Healthcare Management

Background:

• Antimicrobial resistance necessitates improved surgical antibiotic prophylaxis (SAP) use.
• Current compliance with SAP guidelines remains suboptimal.
• This study evaluated SAP guideline adherence in neurosurgery within Brazilian hospitals.

Purpose of the Study:

• To determine the level of compliance with SAP guidelines in neurosurgery.
• To identify institutional factors associated with SAP guideline compliance.

Main Methods:

• Assessed surgeries across 9 Brazilian hospitals.
• Utilized medical record reviews and questionnaires to evaluate compliance with six SAP attributes.
• Employed logistic and linear regressions to analyze associations between compliance and patient/hospital characteristics.

Main Results:

• Full compliance with SAP guidelines was observed in only 10% of cases.
• Compliance was associated with infection control personnel hours, guideline dissemination, monitoring, and feedback.
• Daytime and spinal procedures showed higher compliance for specific attributes like drug dose, timing, and duration.

Conclusions:

• A significant gap in SAP guideline adherence was identified.
• Enhanced stewardship approaches, including targeted training, are crucial for improving compliance.
• Effective monitoring, feedback mechanisms, and collaboration between infection control and surgical teams are vital.