Surgeon-Led Antibiotic Time-Outs After Emergency Abdominal Surgery.

Area of Science:

• Surgery
• Infectious Diseases
• Antimicrobial Stewardship

Background:

• Antimicrobial resistance is a global health crisis driven by excessive antibiotic use.
• Antibiotic agent time-outs (ATO) are recommended but their efficacy post-emergency abdominal surgery is unclear.

Purpose of the Study:

• To evaluate if incorporating ATOs into routine post-operative rounds could shorten antibiotic treatment duration.
• To assess the impact of ATOs on patient outcomes after emergency abdominal operations.

Main Methods:

• A single-center, retrospective study of adult patients undergoing emergency abdominal surgery for intra-abdominal infection.
• Surgeons implemented daily ATOs to reassess antimicrobial agent regimens from January 2018.
• Segmented regression analysis compared pre- and post-intervention trends.

Main Results:

• The mean duration of post-operative antibiotic therapy decreased from 6.7 to 5.8 days.
• Meropenem exposure reduced significantly.
• No significant changes were observed in surgical site infection rates, overall complications, or hospital stay duration.

Conclusions:

• Surgeon-led ATOs integrated into daily rounds were associated with shorter post-operative antimicrobial agent duration.
• The reduction in antibiotic duration did not reach statistical significance but did not worsen clinical outcomes.
• This low-resource intervention supports surgical antimicrobial stewardship and warrants broader consideration.