Efficacy and compliance of an administrative MDT-driven antimicrobial prophylaxis protocol in Class I incisions: a...

Perioperative antibiotic prophylaxis plays a key role in preventing surgical site infections (SSIs). However, inappropriate use may increase the risk of antimicrobial resistance and SSIs. This study aims to evaluate the use of perioperative prophylactic antibiotics in Class I incisions after implementing administrative multidisciplinary team (MDT) interventions and assess the effectiveness of these interventions in improving management practices.

Retrospective collection of perioperative data from 2017 served as baseline data. The administrative intervention was divided into three phases: Phase I: The administrative Multi-departmental team (MDT) was composed of Medical Affairs Department, Hospital Infection Management Department, and Pharmacy Department (January 2018-December 2019). During this phase, the three departments will collaboratively conduct surveillance, evaluation, and public reporting on perioperative antimicrobial prophylaxis for Class I (clean) incisions and organize targeted training initiatives based on the findings. Phase II: The "administrative MDT" model will now be comprehensively expanded and integrated into key areas of our healthcare system, encompassing the Nursing department, Operating room, Anesthesiology department, and various clinical units. This strategic development will span a multi-department joint intervention phase, commencing from January 2020 and concluding in December 2022; Simultaneously, targeted improvement measures were implemented to address issues identified in Phase I. Phase III: Continuous follow-up (January 2023-December 2024), To evaluate the improvement effectiveness of each intervention phase compared to the baseline monitoring results.

After administrative interventions, all monitoring indicators for prophylactic antibiotic use in Class I incisions showed significant improvement: The prophylactic antibiotic use rate for Class I incisions decreased from 33.72% (7,168/21259) at baseline to 29.01% (24,314/83804) in Phase II and further to 25.91% (19,757/76259) in Phase III, which were statistically significant different (p = 0.000 < 0.05). The average score rate of surgical staff on antibiotic-related knowledge assessments increased from 70.83% at baseline to 96.33% in Phase II, and high at 95.41% in Phase III. The incidence of Class I incision infections decreased slightly from 0.11% at baseline to 0.09% in Phase II, and to 0.10% in Phase III (No statistically significant difference). The results demonstrate that MDT intervention was associated with a decrease in antimicrobial use, and no significant increase in surgical site infection (SSI) rates was observed.

This study applied the "Administrative MDT Model" to the management of prophylactic antibiotic use in Class I incisions, As a result, the utilization rate of prophylactic antibiotics for these procedures was significantly reduced. The "Administrative MDT Model," effectively reduced unnecessary antibiotic use while maintaining low infection rates.