J Prev Med Public Health.
2009 Jan;42(1):12-20. 10.3961/jpmph.2009.42.1.12.
Association between the Pattern of Prophylactic Antibiotic Use and Surgical Site Infection Rate for Major Surgeries in Korea
- Affiliations
-
- 1Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea. yoonkim@snu.ac.kr
- 2Institute of Health Policy and Management, SNUMRC, Seoul, Korea.
- 3Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 4Department of Public Health and Health Care Management, Inje Institute of Advanced Studies, Seoul, Korea.
- KMID: 792603
- DOI: http://doi.org/10.3961/jpmph.2009.42.1.12
Abstract
OBJECTIVES
The purpose of this study was to analyze the association between the pattern of prophylactic antibiotic use (PAU) and the surgical site infection (SSI) rate for major surgeries in Korea.
METHODS
We retrospectively reviewed the medical records of patients who underwent cardiac, colon and gastric surgery, hysterectomies and hip/knee replacements at 20 hospitals, and inclusive of over 500 beds. We randomly sampled 60 cases per surgery type for patients discharged between September and November, 2006. A total fo 2,924 cases were included in our analysis. Cox's proportional hazard analysis was conducted to evaluate the association between the pattern of PAU and SSI rate.
RESULTS
The proportion of patients who received their first prophylactic antibiotics (PA) 1 hour before incision was 65.5%, who received inappropriate PAs was 80.8%, and the proportion of patients whose PA was discontinued within 24 hours of surgery was 0.5%. The average duration of PAU after surgery was 9 days. The relative risk (RR) of SSI in patients who received their first PA more than 1 hour before incision was significantly higher than for those who received it within 1 hour prior to incision (RR=8.20, 95% CI=4.81-13.99). Inappropriate PA selection increased SSI rate, albeit with marginal significance (RR=1.97, 95% CI=0.96-4.03). Also, prolonged PAU following surgery had no effect on SSI rate.
CONCLUSIONS
These results suggest that the pattern of PAU in the surgeries examined was not appropriate. Errors in the timing of PAU and of PA selection increase SSI rate. SSI rate remained unaltered following prolonged PAU after surgery.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Association Between Prophylactic Antibiotic Use and Surgical Site Infection Based on Quality Assessment Data in Korea
- The role of prophylactic antibiotics on surgical site infection in elective laparoscopic cholecystectomy
- Comparison of erythrocyte sedimentation rate and C-reactive protein in patients with distal radius fractures according to the prophylactic antibiotic period: 1 day versus 1 week
- Comparison of Infection Rates according to the Period of Prophylactic Antibiotic Use after Surgery in Patients with Distal Radius Fractures
- Feasibility of No Prophylactic Antibiotics Use in Patients Undergoing Total Laparoscopic Distal Gastrectomy for Gastric Carcinoma: a Propensity Score-Matched Case-Control Study
