Evaluation of Surgical Antimicrobial Prophylaxis Compliance: A Multicentre Point Prevalence Study.

Abstract

Background: This study aimed to determine the frequency of compliance with surgical prophylaxis in Turkey and to identify the causes and risk factors for non-compliance.

Methods: This multi-center, prospective, point prevalence study was conducted in eight hospitals from different regions of Turkey. Patients over 18 years who underwent surgical antimicrobial prophylaxis (SAP) in all hospital surgical units were included in the study. The SAP compliance assessment was carried out under five headings; unnecessary prophylaxis, inappropriate drug choice, prolonged prophylaxis, inappropriate dose interval, and inappropriate dosage.

Results: The study included 541 patients from 8 centers. 52.7% (n=285) were female and the median age was 54 years (min-max: 18-94). Orthopedics (23.7%, n=128), general surgery (22.2%, n=120), and obstetrics and gynecology (14.6%, n=79) were the most common specialties. SAP compliance was 14%. The specialty with the highest rate of inappropriate SAP was orthopedics (97%, n=124/128) and the lowest rate was in ophthalmology (25%, n=2). The most common causes of inappropriate surgical prophylaxis were prolonged prophylaxis (92.0%, n=299) and inappropriate dose interval (84.6%, n=275). Multivariate logistic regression analysis revealed that prolonged surgical time, American Society of Anaesthesiologists (ASA) score 3, and some specialties increased the risk of non-compliance with surgical prophylaxis.

Conclusion: Our study showed that SAP compliance is low in Turkey and that inappropriateness is caused mostly by prolonged and inappropriate antimicrobial use.