Adherence to Guideline-Based Antibiotic Prophylaxis in Gynecology among Alabama Providers. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Howard, Tera; Tita, Alan; Dimperio, Lisa; Harper, Lorie
• Is Part Of: Southern medical journal. Volume 113:Issue 4(2020)
• Publication Date: 2020-04
• Subjects: antibiotic prophylaxis -- antibiotic stewardship -- guidelines -- gynecology; Medicine -- Periodicals; 610.5
• DOI: 10.14423/SMJ.0000000000001085
• Languages: English
• ISSNs: 0038-4348

Abstract

Abstract : Objectives: Surgical site infection (SSI) is a preventable cause of postoperative morbidity. The appropriate use of perioperative antibiotics for prevention of SSIs is a well-established quality metric. Little is known about the adherence to guidelines-based antibiotic prophylaxis among Alabama obstetricians and gynecologists. Our aims were to determine their adherence to guidelines-based antibiotic prophylaxis and identify the factors that are predictive of nonadherence. Methods: Online, self-administered survey of Alabama obstetricians and gynecologists. Results: Providers reported not providing the indicated antibiotics and/or giving nonindicated antibiotics in almost all surgical scenarios. The exceptions included hysterectomies, in which almost all (96%) providers routinely gave indicated antibiotics. No providers reported giving antibiotics during intrauterine device placement or endometrial biopsies, which is appropriate. The only factor predictive of inappropriate antibiotic use was the absence of a standing antibiotic protocol. Conclusions: Alabama gynecologic surgeons can and should improve their compliance with guidelines-based antibiotic prophylaxis. More research is needed to determine which interventions would improve adherence in this provider population; our study suggests that the implementation of a standing antibiotic protocol may be a reasonable first step. Abstract : The authors sought to determine how well Alabama providers adhere to guidelines-based recommendations for antibiotic prophylaxis in gynecologic surgery. They also sought to identify factors that are associated with inappropriate antibiotic use. The results of such an investigation are important, given the recent emphasis on antibiotic stewardship and surgical quality metrics.