Effect of intervention on prophylactic use of antibiotics in clean surgical incisions during perioperative period

Objective To evaluate the effect of intervention on prophylactic antibiotic use in clean operations during perioperative period. Methods Clinical data from discharged patients with clean surgical incisions were collected from the Xiaoshan Third People’s Hospital, including 276 admitted from April to November 2010 (pre-intervention group), 439 admitted from April to November 2013 (first intervention group) and 443 patients admitted from April to November 2014 (second intervention group). The utilization, medication time, course of drugs treatment and types of antibacterial drugs during perioperative period were retrospectively analyzed among three groups. Kruskal-Wallis test and χ2 test were used to analyze data. Results Prophylactic antibacterial utilization rate was 97.10%(268/276) before intervention, which dropped to 31.44%(138/439) and 11.74%(52/443) after first and second intervention, while the rates of rational drug use increased from 10.45%(28/268) to 36.23% (50/138) and 86.54%(45/52)(χ2=537.78 and 137.20, P<0.01). The course of antimicrobial drug treatment was 6 (3-7) d before intervention, which was shortened to 1 (1-2) d and 1(1-2) d after the first and second intervention (χ2=214.77, P<0.01), respectively, the proportion of patients with perioperative prophylactic use of antimicrobial agents 0.5-2 h before operation increased(χ2=85.976, P<0.01). The use of first- and second-generation cephalosporins increased from 37.31%(100/268) to 88.64% (46/52) after second intervention. Conclusion After interventions, the prophylactic use of antimicrobial drugs in clean surgical incisions during perioperative period is reduced, accompanied by increase in rational drug utilization. Key words: Anti-bacterial agents; Perioperative; Protective agents; Clean surgical incision; Intervention studies