Evaluation of surgical antimicrobial prophylaxis compliance: A multicenter point prevalence study

This study aimed to determine the frequency of compliance with surgical antimicrobial prophylaxis (SAP) in Turkey and to identify the causes for noncompliance.

This multicenter, prospective, point prevalence study was conducted in 8 hospitals from different regions of Turkey. Patients over 18years who underwent SAP in all hospital surgical units were included. The SAP compliance assessment was carried out under 5 headings: unnecessary prophylaxis, inappropriate drug choice, prolonged prophylaxis, inappropriate dose interval, and inappropriate dosage.

The study included 541 patients from 8 centers. About 52.7% (n=285) were female and the median age was 54years (min-max: 18-94). Orthopedics (23.7%) and general surgery (22.2%) were the most common specialties. SAP compliance was 14%. The specialty with the highest rate of inappropriate SAP was orthopedics (97%) and the lowest rate was in ophthalmology (25%). The most common causes of inappropriate SAP were prolonged prophylaxis (92.0%) and inappropriate dose interval (84.6%). Multivariate logistic regression analysis revealed that prolonged surgical time, American Society of Anaesthesiologists (ASA) score 3, and some specialties increased the risk of noncompliance with surgical prophylaxis.

This study showed that SAP compliance is low in Turkey and that inappropriateness is caused mostly by prolonged and inappropriate antimicrobial use.