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Auto-Substitutions to Optimize Perioperative Antimicrobial Prophylaxis: Pre-Post Intervention Study.

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Implementing evidence-based antibiotic guidelines in Otolaryngology-Head and Neck Surgery improved compliance, mainly through correct dosing. Future efforts will focus on agent selection to further enhance patient safety and reduce healthcare costs.

Keywords:
antimicrobial prophylaxisantimicrobial stewardshipauto-substitutionselectronic medical recordsperioperative antibiotics

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Area of Science:

  • Otolaryngology-Head and Neck Surgery
  • Infectious Disease Prevention
  • Healthcare Quality Improvement

Background:

  • Perioperative antibiotic administration is crucial for preventing surgical site infections, antimicrobial resistance, and reducing healthcare costs in Otolaryngology-Head and Neck Surgery (OHNS).
  • Suboptimal adherence to antibiotic prophylaxis guidelines can lead to adverse patient outcomes and increased system burden.

Purpose of the Study:

  • To achieve 90% compliance with evidence-based perioperative antibiotic prophylaxis guidelines for elective surgical procedures within OHNS.
  • To evaluate the impact of targeted interventions on adherence to antibiotic prophylaxis protocols.

Main Methods:

  • A pre-intervention (September 2019-2020) and post-intervention (October 2020-May 2021) study design was employed.
  • Interventions included educational grand rounds and electronic health record modifications.
  • Compliance was assessed based on antibiotic agent and dose selection, with staff and resident perceptions surveyed.

Main Results:

  • Overall compliance with antibiotic prophylaxis guidelines significantly improved from 38.8% to 59.0% (p < 0.001).
  • Dose compliance saw a substantial increase from 39.6% to 89.2% (p < 0.001).
  • Agent compliance showed no significant improvement (60.7% to 62.8%, p = 0.68), though 78.5% of respondents agreed with following guidelines.

Conclusions:

  • Perioperative antibiotic prophylaxis compliance in OHNS can be improved, particularly through enhanced dosing adherence.
  • Future interventions should address agent compliance and specific procedures with lower adherence rates.
  • Optimizing antibiotic use is essential for patient safety and effective healthcare delivery.