A Collaborative Intervention to Improve Surgical Antibiotic Prophylaxis in Children: Results from a Prospective Multicenter Study

Overview

Journal Eur J Clin Pharmacol

Specialty Pharmacology

Date 2017 Jun 9

PMID 28593400

Citations 3

Authors

Marta Ciofi Degli Atti

Stefania Spila Alegiani

Roberto Raschetti

Pasquale Arace

Angela Giusti

Raffaele Spiazzi

Massimiliano Raponi

Affiliations

Soon will be listed here.

Abstract

Purpose: The use of surgical antibiotic prophylaxis (SAP) in children is poorly characterized. Our aim was to evaluate the effectiveness of a quality improvement (QI) intervention targeting SAP in children, by means of a multicenter prospective intervention study, with a before and after design.

Methods: We prospectively investigated elective surgical procedures performed in children <18 years, prior to the QI intervention, after the intervention and at 9-month follow-up. The primary outcomes were adherence to SAP indications and SAP appropriateness, defined considering antibiotic choice, timing of first dose and duration of administration. We compared SAP adherence and appropriateness prior the QI intervention, to the post-intervention and the follow-up. We considered patient and procedure characteristics as covariates in two logistic regression models to assess the effect of the QI intervention on SAP adherence and appropriateness.

Results: We collected information on 2383 procedures (pre-intervention: 784; post-intervention: 790; follow-up: 809). The QI intervention had a significant impact on the adherence to SAP indications (86.6% in the post-intervention, compared to 82.0% prior to the intervention; p < 0.05), and on its appropriateness (35.7% compared to 19.9%; p < 0.01). The impact of the intervention on SAP appropriateness was maintained at follow-up (38.3%; p < 0.01 compared to pre-intervention). All components of SAP appropriateness significantly improved after the intervention and at follow-up. The logistic regression analyses confirmed the effect of intervention in improving adherence to SAP indications and appropriateness.

Conclusions: Following the QI intervention, there was a significant improvement in quality of SAP in pediatric surgery, though more efforts are needed to increase SAP appropriateness.

Citing Articles

Effectiveness and Sustainability of an Antimicrobial Stewardship Program for Perioperative Prophylaxis in Pediatric Surgery.

Dona D, Luise D, Barbieri E, Masiero N, Maita S, Antoniello L Pathogens. 2020; 9(6).

PMID: 32575542 PMC: 7350339. DOI: 10.3390/pathogens9060490.

Implementation and impact of pediatric antimicrobial stewardship programs: a systematic scoping review.

Dona D, Barbieri E, Daverio M, Lundin R, Giaquinto C, Zaoutis T Antimicrob Resist Infect Control. 2020; 9(1):3.

PMID: 31911831 PMC: 6942341. DOI: 10.1186/s13756-019-0659-3.

Impact of pharmacist-led antibiotic stewardship interventions on compliance with surgical antibiotic prophylaxis in obstetric and gynecologic surgeries in Nigeria.

Abubakar U, Syed Sulaiman S, Adesiyun A PLoS One. 2019; 14(3):e0213395.

PMID: 30845240 PMC: 6405127. DOI: 10.1371/journal.pone.0213395.

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