Appropriateness of antibacterial agents administration for perioperative prophylaxis in surgical patients

Aim

To evaluate the appropriateness and safety of perioperative prophylaxis of surgical site infections (SSI).

Material and methods

We retrospectively studied medical records of 576 patients (347 males, age from 18 to 87 years) who underwent major surgery.

Results

The choice of antibacterial drugs for perioperative prophylaxis of SSI conformed with the recommendations in 43% of cases. Duration of perioperative prophylaxis and dosing of antibiotics were inadequate in 79.7% and 46.7% cases, respectively. The inappropriate choice of antibacterial regimen was associated with ICU stay (p=0.003), while inadequate dosing was associated with the frequency of surgical interventions for infectious complications (p=0.001), ICU stay (p=0.005) and mortality (p=0.002). Inappropriate duration of perioperative prophylaxis in patients with renal dysfunction predicted the development of ADR (p<0.0001), infections (p=0.006), increased duration of ICU stay (p=0.049), duration of hospitalization (p<0.001), and risk of death (p=0.003).

Conclusion

In real clinical practice, the recommendations for perioperative prophylaxis of SSI are not followed. Inappropriate duration of perioperative prophylaxis of SSI and dosing regimen have negative impact on performance indicators.

Key words

Antibacтитутаterial agents, pereoperative prophilaxis. infections. adverse drug reactions.