Compliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa

dc.contributor.advisorPiercy, Jenna
dc.contributor.advisorFagan Johannes
dc.contributor.authorSchuster, Delia
dc.date.accessioned2021-02-24T09:42:02Z
dc.date.available2021-02-24T09:42:02Z
dc.date.issued2020
dc.date.updated2021-02-24T09:41:42Z
dc.description.abstractBackground: The aim of surgical antibiotic prophylaxis (SAP) is to prevent surgical site infection (SSI) by administering an appropriate antimicrobial agent perioperatively. However, SAP may be associated with adverse effects and incurs added costs. The primary objective of this prospective study is to establish whether clinicians are adhering to existing perioperative antibiotic prophylaxis guidelines in terms of indication, dosage and timing of SAP. Secondary objectives are to determine the proportion of patients receiving inappropriate antibiotics; and to evaluate correct practice concerning re-dosing and duration of SAP. Methods: A cross-sectional prospective audit of the anaesthetic records and prescription charts of surgical patients was conducted at Groote Schuur Hospital, a tertiary level teaching hospital in Cape Town, South Africa, over a period of one week. Data were collected by anaesthetists – blinded to the study objectives – and the investigators; then captured on Excel spread sheets and compared to existing SAP guidelines. Descriptive statistics and binary logistic regression were used for analysis. Results: Of the 192 patients consented, 180 questionnaires were completed for data analysis. The median age of participants was 44.5 years (IQR: 31.5-58), with a preponderance of females (58.7%). SAP was administered in 149 cases (82.8%) and withheld in 31 (17.2%). This was appropriate in 91.9% (137/149) and 77.4% (24/31) respectively. Twelve patients (6.7%) received inappropriate antibiotics and in seven (3.9%) it was inappropriately withheld. Of the 156 patients who should have received SAP, choice of drug was correct in 121 (77.6%), dosage in 110 (70.5%) and timing in 87 (55.8%). Absolute compliance was achieved in 44.4% (80/180). Errors were mostly related to timing, re-dosing and duration of SAP. Conclusion: Anaesthetists and surgeons at Groote Schuur Hospital demonstrate variable adherence to surgical antibiotic prophylaxis guidelines. Interventions aimed at improving compliance are warranted.
dc.identifier.apacitationSchuster, D. (2020). <i>Compliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa</i>. (). ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. Retrieved from http://hdl.handle.net/11427/32965en_ZA
dc.identifier.chicagocitationSchuster, Delia. <i>"Compliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa."</i> ., ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2020. http://hdl.handle.net/11427/32965en_ZA
dc.identifier.citationSchuster, D. 2020. Compliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa. . ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. http://hdl.handle.net/11427/32965en_ZA
dc.identifier.ris TY - Master Thesis AU - Schuster, Delia AB - Background: The aim of surgical antibiotic prophylaxis (SAP) is to prevent surgical site infection (SSI) by administering an appropriate antimicrobial agent perioperatively. However, SAP may be associated with adverse effects and incurs added costs. The primary objective of this prospective study is to establish whether clinicians are adhering to existing perioperative antibiotic prophylaxis guidelines in terms of indication, dosage and timing of SAP. Secondary objectives are to determine the proportion of patients receiving inappropriate antibiotics; and to evaluate correct practice concerning re-dosing and duration of SAP. Methods: A cross-sectional prospective audit of the anaesthetic records and prescription charts of surgical patients was conducted at Groote Schuur Hospital, a tertiary level teaching hospital in Cape Town, South Africa, over a period of one week. Data were collected by anaesthetists – blinded to the study objectives – and the investigators; then captured on Excel spread sheets and compared to existing SAP guidelines. Descriptive statistics and binary logistic regression were used for analysis. Results: Of the 192 patients consented, 180 questionnaires were completed for data analysis. The median age of participants was 44.5 years (IQR: 31.5-58), with a preponderance of females (58.7%). SAP was administered in 149 cases (82.8%) and withheld in 31 (17.2%). This was appropriate in 91.9% (137/149) and 77.4% (24/31) respectively. Twelve patients (6.7%) received inappropriate antibiotics and in seven (3.9%) it was inappropriately withheld. Of the 156 patients who should have received SAP, choice of drug was correct in 121 (77.6%), dosage in 110 (70.5%) and timing in 87 (55.8%). Absolute compliance was achieved in 44.4% (80/180). Errors were mostly related to timing, re-dosing and duration of SAP. Conclusion: Anaesthetists and surgeons at Groote Schuur Hospital demonstrate variable adherence to surgical antibiotic prophylaxis guidelines. Interventions aimed at improving compliance are warranted. DA - 2020 DB - OpenUCT DP - University of Cape Town KW - surgical antibiotic prophylaxis KW - adherence KW - compliance KW - guidelines KW - surgical site infection LK - https://open.uct.ac.za PY - 2020 T1 - Compliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa TI - Compliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa UR - http://hdl.handle.net/11427/32965 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/32965
dc.identifier.vancouvercitationSchuster D. Compliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa. []. ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2020 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/32965en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Anaesthesia and Perioperative Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectsurgical antibiotic prophylaxis
dc.subjectadherence
dc.subjectcompliance
dc.subjectguidelines
dc.subjectsurgical site infection
dc.titleCompliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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