J Korean Orthop Assoc.  2009 Apr;44(2):159-164.

Protocol for Administration of Prophylactic Antibiotics within One Hour before the Surgical Incision in Total Hip and Knee Replacement

• Song EK
• Yoon TR
• Park SJ
• Park KS
• Jung WB

Abstract

PURPOSE
We aimed that compliance could be improved by new protocol ensuring the adequate timing of intravenous antibiotic delivery onto an already existing time out system used to ensure exact surgical site. MATERIALS AND METHODS: A group of 150 patients was administered prophylactic antibiotics just before entering operation room and performed only time-out protocol. Other group of 150 patients was administered prophylactic antibiotics directly after anesthetic induction and perfomed new protocol inclusive of checklist ensuring appropriate timing of antimicrobial prophylaxis. We compared mean time from prophylactic administration to surgical incision and compliance. RESULTS: The average time from administration of the antimicrobial prophylaxis to the surgical incision for patients who was performed only time-out protocol was 43 minutes and compliance was 60.6%. The average time from administration of the antimicrobial prophylaxis to the surgical incision for patients who was performed new protocol was 18 minutes and compliance was 100%. There was a significant difference in compliance of two groups. CONCLUSION: New protocol ensuring the adequate timing of intravenous antibiotic delivery combined with administration of the antimicrobial prophylaxis directly after anesthetic induction were effective and easily adaptable method to ensure compliance with appropriate timing of prophylactic antibiotics.

Keyword

Total joint replacement; Prophylactic antibiotics; Compliance

MeSH Terms

Anti-Bacterial Agents
Checklist
Compliance
Dietary Sucrose
Hip
Humans
Knee
Anti-Bacterial Agents
Dietary Sucrose

Figure

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  Fig. 1 New vertification protocol including the checklists of time-out and administration of preoperative antibiotics.

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  Fig. 2 Distribution of timing of antibiotic administration in patients before peforming new protocol by twenty-minute groupings.

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  Fig. 3 Distribution of timing of antibiotic administration in patients after performing new protocol by fifteen-minute groupings.

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