Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses
Objective To describe perioperative antimicrobial use in horses undergoing elective arthroscopy. Study design. Retrospective study. Sample population. Horses that underwent elective arthroscopy at one institution between July 2016 and May 2018, excluding those with a suspected infectious orthopedic...
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| Veröffentlicht in: | Veterinary surgery 2020-04, Vol.49 (3), p.427-435 |
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| creator | Muntwyler, Noah Dubois, Marie‐Soleil Weese, J. Scott |
| description | Objective
To describe perioperative antimicrobial use in horses undergoing elective arthroscopy.
Study design.
Retrospective study.
Sample population.
Horses that underwent elective arthroscopy at one institution between July 2016 and May 2018, excluding those with a suspected infectious orthopedic disease or with a comorbidity that may have impacted prophylactic antimicrobial use decisions.
Methods
Medical records were reviewed to evaluate preoperative, intraoperative, and postoperative antimicrobial drug selection, dose, and timing. Associations between body weight and underdosing were evaluated by using analysis of variance, χ2 test was used for categorical comparisons, and least squares fit was used to evaluate factors associated with duration of postoperative antimicrobials.
Results
Among 150 horses, 149 (99.3%) received systemic preoperative antimicrobials. Only 53 (40.2%) horses were administered doses within 60 minutes of surgical incision. First incision was performed more than two half‐lives after administration of sodium penicillin in 46 of 131 (35.1%) horses but in only 1 of 106 (0.8%) horses that received trimethoprim‐sulfadoxine. Body weight was associated with underdosing for penicillin (P = .0075) and trimethoprim‐sulfadoxine (P = .002) but not gentamicin (P = .92). Twenty‐six (17%) horses received one postoperative antimicrobial dose, while antimicrobials were continued in hospital for a mean of 22.3 ± 4.4 hours after surgery in the other 123 horses. Among the 149 discharged horses, 115 (77.2%) were prescribed antimicrobials after discharge (range, 3‐10 days; median, 3 days, interquartile range, 0 days).
Conclusion
Deviations from common recommendations were apparent and provide evidence for the requirement to develop interventions to optimize perioperative prophylaxis.
Clinical significance
Perioperative antimicrobial use practices should be regularly assessed to provide a benchmark and identify areas for intervention. |
| doi_str_mv | 10.1111/vsu.13382 |
| format | Article |
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To describe perioperative antimicrobial use in horses undergoing elective arthroscopy.
Study design.
Retrospective study.
Sample population.
Horses that underwent elective arthroscopy at one institution between July 2016 and May 2018, excluding those with a suspected infectious orthopedic disease or with a comorbidity that may have impacted prophylactic antimicrobial use decisions.
Methods
Medical records were reviewed to evaluate preoperative, intraoperative, and postoperative antimicrobial drug selection, dose, and timing. Associations between body weight and underdosing were evaluated by using analysis of variance, χ2 test was used for categorical comparisons, and least squares fit was used to evaluate factors associated with duration of postoperative antimicrobials.
Results
Among 150 horses, 149 (99.3%) received systemic preoperative antimicrobials. Only 53 (40.2%) horses were administered doses within 60 minutes of surgical incision. First incision was performed more than two half‐lives after administration of sodium penicillin in 46 of 131 (35.1%) horses but in only 1 of 106 (0.8%) horses that received trimethoprim‐sulfadoxine. Body weight was associated with underdosing for penicillin (P = .0075) and trimethoprim‐sulfadoxine (P = .002) but not gentamicin (P = .92). Twenty‐six (17%) horses received one postoperative antimicrobial dose, while antimicrobials were continued in hospital for a mean of 22.3 ± 4.4 hours after surgery in the other 123 horses. Among the 149 discharged horses, 115 (77.2%) were prescribed antimicrobials after discharge (range, 3‐10 days; median, 3 days, interquartile range, 0 days).
Conclusion
Deviations from common recommendations were apparent and provide evidence for the requirement to develop interventions to optimize perioperative prophylaxis.
Clinical significance
Perioperative antimicrobial use practices should be regularly assessed to provide a benchmark and identify areas for intervention.</description><identifier>ISSN: 0161-3499</identifier><identifier>EISSN: 1532-950X</identifier><identifier>DOI: 10.1111/vsu.13382</identifier><identifier>PMID: 31950522</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Antiinfectives and antibacterials ; Antimicrobial agents ; Arthroscopy ; Body weight ; Chi-square test ; Discharge ; Evaluation ; Gentamicin ; Horses ; Medical records ; Orthopedics ; Penicillin ; Population studies ; Prophylaxis ; Statistical tests ; Sulfadoxine ; Surgery ; Trimethoprim ; Variance analysis</subject><ispartof>Veterinary surgery, 2020-04, Vol.49 (3), p.427-435</ispartof><rights>2020 The American College of Veterinary Surgeons</rights><rights>2020 The American College of Veterinary Surgeons.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3202-30f143401926a3efa4830c5ce5f9a776e420cf630797186340c0fe318873cb03</citedby><cites>FETCH-LOGICAL-c3202-30f143401926a3efa4830c5ce5f9a776e420cf630797186340c0fe318873cb03</cites><orcidid>0000-0003-1896-1937</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fvsu.13382$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fvsu.13382$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31950522$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Muntwyler, Noah</creatorcontrib><creatorcontrib>Dubois, Marie‐Soleil</creatorcontrib><creatorcontrib>Weese, J. Scott</creatorcontrib><title>Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses</title><title>Veterinary surgery</title><addtitle>Vet Surg</addtitle><description>Objective
To describe perioperative antimicrobial use in horses undergoing elective arthroscopy.
Study design.
Retrospective study.
Sample population.
Horses that underwent elective arthroscopy at one institution between July 2016 and May 2018, excluding those with a suspected infectious orthopedic disease or with a comorbidity that may have impacted prophylactic antimicrobial use decisions.
Methods
Medical records were reviewed to evaluate preoperative, intraoperative, and postoperative antimicrobial drug selection, dose, and timing. Associations between body weight and underdosing were evaluated by using analysis of variance, χ2 test was used for categorical comparisons, and least squares fit was used to evaluate factors associated with duration of postoperative antimicrobials.
Results
Among 150 horses, 149 (99.3%) received systemic preoperative antimicrobials. Only 53 (40.2%) horses were administered doses within 60 minutes of surgical incision. First incision was performed more than two half‐lives after administration of sodium penicillin in 46 of 131 (35.1%) horses but in only 1 of 106 (0.8%) horses that received trimethoprim‐sulfadoxine. Body weight was associated with underdosing for penicillin (P = .0075) and trimethoprim‐sulfadoxine (P = .002) but not gentamicin (P = .92). Twenty‐six (17%) horses received one postoperative antimicrobial dose, while antimicrobials were continued in hospital for a mean of 22.3 ± 4.4 hours after surgery in the other 123 horses. Among the 149 discharged horses, 115 (77.2%) were prescribed antimicrobials after discharge (range, 3‐10 days; median, 3 days, interquartile range, 0 days).
Conclusion
Deviations from common recommendations were apparent and provide evidence for the requirement to develop interventions to optimize perioperative prophylaxis.
Clinical significance
Perioperative antimicrobial use practices should be regularly assessed to provide a benchmark and identify areas for intervention.</description><subject>Antiinfectives and antibacterials</subject><subject>Antimicrobial agents</subject><subject>Arthroscopy</subject><subject>Body weight</subject><subject>Chi-square test</subject><subject>Discharge</subject><subject>Evaluation</subject><subject>Gentamicin</subject><subject>Horses</subject><subject>Medical records</subject><subject>Orthopedics</subject><subject>Penicillin</subject><subject>Population studies</subject><subject>Prophylaxis</subject><subject>Statistical tests</subject><subject>Sulfadoxine</subject><subject>Surgery</subject><subject>Trimethoprim</subject><subject>Variance analysis</subject><issn>0161-3499</issn><issn>1532-950X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kE1LAzEQhoMotlYP_gEJePKwbZLZj-xRil9QELSKJ5c0TuiW3WZNdiv990a39WYOk8M88wzzEnLO2ZiHN9n4bswBpDggQ56AiPKEvR2SIeMpjyDO8wE58X7FGMvjGI7JAHggEiGG5P0JW2d9g7otN0iV9-h9jeuWWkMbdKUNRfW9dVvWpXZ2UaqKdh6psY5itR917TKYtG22tFzTpXVBdUqOjKo8nu3-EZnf3syn99Hs8e5hej2LNAgmImCGxxAznotUARoVS2A60ZiYXGVZirFg2qTAsjzjMg2kZgaBS5mBXjAYkcte2zj72aFvi5Xt3DpsLARIkGmaSh6oq54KN3jv0BSNK2vltgVnxU-QRQiy-A0ysBc7Y7eo8eOP3CcXgEkPfJUVbv83Fa_PL73yG7iWfco</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Muntwyler, Noah</creator><creator>Dubois, Marie‐Soleil</creator><creator>Weese, J. Scott</creator><general>John Wiley & Sons, Inc</general><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>M7Z</scope><scope>P64</scope><orcidid>https://orcid.org/0000-0003-1896-1937</orcidid></search><sort><creationdate>202004</creationdate><title>Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses</title><author>Muntwyler, Noah ; Dubois, Marie‐Soleil ; Weese, J. Scott</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3202-30f143401926a3efa4830c5ce5f9a776e420cf630797186340c0fe318873cb03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Antiinfectives and antibacterials</topic><topic>Antimicrobial agents</topic><topic>Arthroscopy</topic><topic>Body weight</topic><topic>Chi-square test</topic><topic>Discharge</topic><topic>Evaluation</topic><topic>Gentamicin</topic><topic>Horses</topic><topic>Medical records</topic><topic>Orthopedics</topic><topic>Penicillin</topic><topic>Population studies</topic><topic>Prophylaxis</topic><topic>Statistical tests</topic><topic>Sulfadoxine</topic><topic>Surgery</topic><topic>Trimethoprim</topic><topic>Variance analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Muntwyler, Noah</creatorcontrib><creatorcontrib>Dubois, Marie‐Soleil</creatorcontrib><creatorcontrib>Weese, J. Scott</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Veterinary surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Muntwyler, Noah</au><au>Dubois, Marie‐Soleil</au><au>Weese, J. Scott</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses</atitle><jtitle>Veterinary surgery</jtitle><addtitle>Vet Surg</addtitle><date>2020-04</date><risdate>2020</risdate><volume>49</volume><issue>3</issue><spage>427</spage><epage>435</epage><pages>427-435</pages><issn>0161-3499</issn><eissn>1532-950X</eissn><abstract>Objective
To describe perioperative antimicrobial use in horses undergoing elective arthroscopy.
Study design.
Retrospective study.
Sample population.
Horses that underwent elective arthroscopy at one institution between July 2016 and May 2018, excluding those with a suspected infectious orthopedic disease or with a comorbidity that may have impacted prophylactic antimicrobial use decisions.
Methods
Medical records were reviewed to evaluate preoperative, intraoperative, and postoperative antimicrobial drug selection, dose, and timing. Associations between body weight and underdosing were evaluated by using analysis of variance, χ2 test was used for categorical comparisons, and least squares fit was used to evaluate factors associated with duration of postoperative antimicrobials.
Results
Among 150 horses, 149 (99.3%) received systemic preoperative antimicrobials. Only 53 (40.2%) horses were administered doses within 60 minutes of surgical incision. First incision was performed more than two half‐lives after administration of sodium penicillin in 46 of 131 (35.1%) horses but in only 1 of 106 (0.8%) horses that received trimethoprim‐sulfadoxine. Body weight was associated with underdosing for penicillin (P = .0075) and trimethoprim‐sulfadoxine (P = .002) but not gentamicin (P = .92). Twenty‐six (17%) horses received one postoperative antimicrobial dose, while antimicrobials were continued in hospital for a mean of 22.3 ± 4.4 hours after surgery in the other 123 horses. Among the 149 discharged horses, 115 (77.2%) were prescribed antimicrobials after discharge (range, 3‐10 days; median, 3 days, interquartile range, 0 days).
Conclusion
Deviations from common recommendations were apparent and provide evidence for the requirement to develop interventions to optimize perioperative prophylaxis.
Clinical significance
Perioperative antimicrobial use practices should be regularly assessed to provide a benchmark and identify areas for intervention.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31950522</pmid><doi>10.1111/vsu.13382</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1896-1937</orcidid></addata></record> |
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| subjects | Antiinfectives and antibacterials Antimicrobial agents Arthroscopy Body weight Chi-square test Discharge Evaluation Gentamicin Horses Medical records Orthopedics Penicillin Population studies Prophylaxis Statistical tests Sulfadoxine Surgery Trimethoprim Variance analysis |
| title | Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses |
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