The prophylactic uses of antibiotics for the prevention of surgical site infection and the effects: The 3-year experience in a tertiary hospital

Yang, Jiyeon; Kim, Moon-Sook; Kim, Yu-Jeong; Lee, Eun-Bong

Journal of Korean Society Quality Assurance Health Care 2012;18(1): 71.
Published online December 30, 2012.

수술 예방적 항생제의 사용 현황 및 관리전후 효과

양지연¹, 김문숙¹, 김유정¹, 이은봉²

¹서울대학교병원QA팀
²서울대학교병원 내과

The prophylactic uses of antibiotics for the prevention of surgical site infection and the effects: The 3-year experience in a tertiary hospital

Jiyeon Yang¹, Moon-Sook Kim¹, Yu-Jeong Kim¹, Eun-Bong Lee²

¹QA (Quality Assurance) Team, Seoul National University Hospital
²Department of Internal Medicine, Seoul National University Hospital

Abstract

Background
The objective of this study was to examine the effect of management system for the appropriate prophylactic use of antibiotics in surgical patients at a tertiary hospital from 2007 to 2010.
Methods
We collected clinical data of three different surgical procedures(colectomy, heart surgery, hysterectomy) for three months of 2007 and 2010, respectively. The number of total cases was 245(137, 54, 54) in 2007, 240(133, 42, 65) in 2010. We measured the rate of use of inappropriate prophylactic antibiotics, administration within 1 hour prior to the incision and the antibiotics prescription days after surgery. To evaluate the effectiveness of the management system, the results of the two groups(Group1=2007, Group2=2010) were compared by t-test, chi-square test or Fisher's exact test.
Result
The rate of Aminoglycoside uses decreased drastically from 11.4% to 0.8%(P<.001). The selection of 3rd/4th Cephalosporin dropped from 11.8% to 5.8%(P=.020). The combination of antibiotics decreased from 27.8% to 11.7%(P<.001). The antibiotic prescription rate on discharge declined from 11.8% to 2.5%(P<.001) and the number of antibiotics prescription days after surgery was shortened from 4.2 days to 2.3 days(P<.001). No significant difference in the rate of administration within 1 hour between two groups was found. Through 3-year management, 5 out of 6 measures were significantly improved(except the administration within 1 hour). The rate of surgical site infection decreased from 2.4% to 1.3%(P=.504).
Conclusion
The findings demonstrate that the management system for the prophylactic use of antibiotics in surgical patients was effective in decreasing the rate of surgical site infection during 3 years.