Compliance with surgical prophylaxis guidelines in liver and kidney transplantations

Background Patients undergoing solid organ transplantations are at a high risk of surgical site infections. Complying with surgical prophylaxis guidelines minimize post-operative infection rate. Objectives The study aimed to evaluate the compliance with the American Society of Health-System Pharmacists surgical prophylaxis guidelines related to antibiotic selection, dosing, administration time, and duration of surgical prophylaxis in liver and kidney transplantations. However, the re-dosing time was only assessed for liver transplantation cases. Setting The study was conducted at the solid organ transplantation center at King Abdualziz Medical City, Riyadh, Saudi Arabia. Method A retrospective chart review including all patients who had a liver or kidney transplantation from January 2016 to December 2018. Main outcome measure The compliance rate with the surgical prophylaxis guideline related to selecting the recommended antibiotic, dosing, administration time, and antibiotic exposure duration. The re-dosing time was assessed in liver transplantations. Results The study included 54 liver recipients and 163 kidney recipients, with an average age of 56 and 43 years, respectively. The majority of the included patients (68% and 56%) were male in both groups. The compliance rates to the recommendations in liver and kidney operations were 82.6% and 77.09% in terms of the choice of antibiotic, 44.5% and 13.4% in terms of dosing, 31.5% and 43.5% in terms of timing, and 18.47% and 84.36% in terms of duration, respectively. None of liver recipients received a re-dosed antibiotic at the recommended time. Conclusion The study concluded that there was an optimal compliance rate to the choice of antibiotic recommendations in both liver and kidney transplantations. Similarly, a high compliance rate was observed for the duration of antibiotic exposure after kidney transplantations. However, the compliance rate in terms of dosing and administration time was low in both transplantations. Low compliance rates were also observed in the duration of antibiotic exposure and the re-dosing time recommendations in liver transplants.