Implementation of an antibiotic prophylaxis protocol in an intensive care unit

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dc.contributor.authorAlmeida, Silvana Maria de
dc.contributor.authorMarra, Alexandre R.
dc.contributor.authorWey, Sergio B. [UNIFESP]
dc.contributor.authorVictor, Elivane da Silva
dc.contributor.authorPavao dos Santos, Oscar Fernando
dc.contributor.authorEdmond, Michael B.
dc.contributor.institutionHosp Israelita Albert Einstein
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionIIEP
dc.contributor.institutionVirginia Commonwealth Univ
dc.date.accessioned2016-01-24T14:27:49Z
dc.date.available2016-01-24T14:27:49Z
dc.date.issued2012-10-01
dc.description.abstractBackground: When properly employed, the prophylactic use of antimicrobials is associated with a reduction in surgical site infections (SSIs). We found that the appropriate use of antimicrobial prophylaxis was only 50.5% (53/105) among patients undergoing surgery in the adult intensive care unit of our hospital. in 2001, a protocol was designed to improve compliance with recommended practice.Methods: We used a prospective interventional study and a case control study carried out between 2001 and 2007, including follow-up and daily intervention to improve compliance with antimicrobial prophylaxis guidelines and to monitor antimicrobial consumption and SSI rates. Cases of noncompliance to the prophylaxis protocol (group I) were matched to controls (group II) with appropriate prophylaxis and compared with regards to type of surgery, operative duration, intraoperative antimicrobial use, type of antimicrobial used, length of hospital stay, severity of illness, comorbidities, invasive devices, possible adverse reactions, and death.Results: Compliance with antimicrobial prophylaxis metrics reached 85%; however, we were unable to detect a change in SSI rate or consumption and cost of antimicrobials. Inappropriate use was not associated with higher likelihood of death. There were no other significant differences between the 2 groups.Conclusion: Our intervention increased compliance with appropriate antimicrobial surgical prophylaxis with no negative impact on patient safety. Copyright (C) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.en
dc.description.affiliationHosp Israelita Albert Einstein, Intens Care Unit, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Infect Dis, São Paulo, Brazil
dc.description.affiliationIIEP, Dept Stat, São Paulo, Brazil
dc.description.affiliationHosp Israelita Albert Einstein, Div Med Practice, São Paulo, Brazil
dc.description.affiliationVirginia Commonwealth Univ, Sch Med, Dept Internal Med, Richmond, VA USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Infect Dis, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent721-725
dc.identifierhttp://dx.doi.org/10.1016/j.ajic.2011.09.018
dc.identifier.citationAmerican Journal of Infection Control. New York: Mosby-Elsevier, v. 40, n. 8, p. 721-725, 2012.
dc.identifier.doi10.1016/j.ajic.2011.09.018
dc.identifier.issn0196-6553
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/35359
dc.identifier.wosWOS:000309592300012
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofAmerican Journal of Infection Control
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectAntimicrobialen
dc.subjectSurgical site infectionen
dc.subjectComplianceen
dc.titleImplementation of an antibiotic prophylaxis protocol in an intensive care uniten
dc.typeinfo:eu-repo/semantics/article
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