Evaluation of Antibiotic Prophylaxis and Postsurgery Antibiotics for Urological Surgeries at an Academic Medical Center
Objective: The purpose of this study was to evaluate antibiotic use in patients undergoing urological procedures. Methodology: This single-center, IRB-approved, retrospective, observational study was conducted at Grady Health System. Patients were included if they underwent their first inpatient uro...
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| Veröffentlicht in: | Infection control and hospital epidemiology 2020-10, Vol.41 (S1), p.s227-s227 |
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| creator | Drwiega, Emily Rab, Saira Kandiah, Sheetal Kriengkauykiat, Jane Wong, Jordan |
| description | Objective:
The purpose of this study was to evaluate antibiotic use in patients undergoing urological procedures.
Methodology:
This single-center, IRB-approved, retrospective, observational study was conducted at Grady Health System. Patients were included if they underwent their first inpatient urologic procedure between April 1, 2016, and April 1, 2018. Patients were excluded if they were |
| doi_str_mv | 10.1017/ice.2020.773 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2898284138</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2898284138</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1463-b0e080ae41293960b7b75b5b7fb4b576b4acbdd477df463506ef8afbfdab8a393</originalsourceid><addsrcrecordid>eNpNkM9LwzAAhYMoOKc3_4CAVzuTpm2S4xjzB0wc6MBbSNpkZnTNTFK1_73Z5sHTu3zvPfgAuMZoghGmd7bWkxzlaEIpOQEjXJY8qxgpTsEIMc4zlpP3c3ARwgYhRDnHI_A9_5JtL6N1HXQGTrtolXXR1nDp3e5jaOWPDVB2DVy6EEPv19oP_7AAjfNw5V3r1raWLXw9IFanUkw9OK1lo7dp71k3B2Cmu6j9JTgzsg366i_HYHU_f5s9ZouXh6fZdJHVuKhIppBGDEld4JwTXiFFFS1VqahRhSpppQpZq6YpKG1M4ktUacOkUaaRiknCyRjcHHd33n32OkSxcb3v0qXIGWc5KzBhibo9UrV3IXhtxM7brfSDwEjs1YqkVuzViqSW_AJsC27I</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2898284138</pqid></control><display><type>article</type><title>Evaluation of Antibiotic Prophylaxis and Postsurgery Antibiotics for Urological Surgeries at an Academic Medical Center</title><source>ProQuest Central Essentials</source><source>ProQuest Central (Alumni Edition)</source><source>Cambridge Journals</source><source>ProQuest Central UK/Ireland</source><source>ProQuest Central</source><creator>Drwiega, Emily ; Rab, Saira ; Kandiah, Sheetal ; Kriengkauykiat, Jane ; Wong, Jordan</creator><creatorcontrib>Drwiega, Emily ; Rab, Saira ; Kandiah, Sheetal ; Kriengkauykiat, Jane ; Wong, Jordan</creatorcontrib><description>Objective:
The purpose of this study was to evaluate antibiotic use in patients undergoing urological procedures.
Methodology:
This single-center, IRB-approved, retrospective, observational study was conducted at Grady Health System. Patients were included if they underwent their first inpatient urologic procedure between April 1, 2016, and April 1, 2018. Patients were excluded if they were <18 years old, pregnant, or a prisoner. The primary outcome was percentage of overall adherence to our institutional guidelines for surgical prophylaxis as a composite of antibiotic selection, dose, preoperative timing, and postoperative duration. Secondary outcomes include individual components of the composite outcome, nephrotoxicity,
Clostridium difficile
infection, and discharge antibiotic prescriptions. Descriptive statistics were used.
Results:
Of the 100 patients evaluated, 11% achieved adherence with the primary outcome. Of the 89 patients who did not achieve composite outcome, only 8 selected the appropriate perioperative antibiotic. Overall, 30% were dosed appropriately, 47% were administered at the appropriate time with respect to time of incision, and 46% received perioperative antibiotics for no more than 24 hours. Also, 19 patients did not receive perioperative antibiotics. Overall, 14 different perioperative antibiotic regimens were utilized, despite institutional guidelines recommending 1 of 3 options. All 9 patients who developed nephrotoxicity received noncompliant perioperative prophylaxis. No patient developed
Clostridium difficile
infection within 30 days of surgery. Moreover, 58 patients were discharged with a prescription for at least 1 antibiotic.
Conclusions:
Most perioperative antibiotic prophylaxes for genitourinary surgeries are not compliant with institution guideline recommendations. Despite having institutional guidelines, there was a large variety in the antibiotic regimens that patients received. All of the patients identified as having an evaluated antibiotic-related adverse effect did not receive appropriate perioperative antibiotic prophylaxis. More than half of the patients received a prescription at discharge for at least 1 antibiotic.
Funding:
None
Disclosures:
None</description><identifier>ISSN: 0899-823X</identifier><identifier>EISSN: 1559-6834</identifier><identifier>DOI: 10.1017/ice.2020.773</identifier><language>eng</language><publisher>Cambridge: Cambridge University Press</publisher><subject>Antibiotics ; Bacterial infections ; Disease control ; Disease prevention ; Observational studies ; Prophylaxis</subject><ispartof>Infection control and hospital epidemiology, 2020-10, Vol.41 (S1), p.s227-s227</ispartof><rights>2020 by The Society for Healthcare Epidemiology of America. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1463-b0e080ae41293960b7b75b5b7fb4b576b4acbdd477df463506ef8afbfdab8a393</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2898284138/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2898284138?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21388,21389,23256,27924,27925,33530,33703,33744,43659,43787,43805,64385,64389,72469,74104,74283,74302</link.rule.ids></links><search><creatorcontrib>Drwiega, Emily</creatorcontrib><creatorcontrib>Rab, Saira</creatorcontrib><creatorcontrib>Kandiah, Sheetal</creatorcontrib><creatorcontrib>Kriengkauykiat, Jane</creatorcontrib><creatorcontrib>Wong, Jordan</creatorcontrib><title>Evaluation of Antibiotic Prophylaxis and Postsurgery Antibiotics for Urological Surgeries at an Academic Medical Center</title><title>Infection control and hospital epidemiology</title><description>Objective:
The purpose of this study was to evaluate antibiotic use in patients undergoing urological procedures.
Methodology:
This single-center, IRB-approved, retrospective, observational study was conducted at Grady Health System. Patients were included if they underwent their first inpatient urologic procedure between April 1, 2016, and April 1, 2018. Patients were excluded if they were <18 years old, pregnant, or a prisoner. The primary outcome was percentage of overall adherence to our institutional guidelines for surgical prophylaxis as a composite of antibiotic selection, dose, preoperative timing, and postoperative duration. Secondary outcomes include individual components of the composite outcome, nephrotoxicity,
Clostridium difficile
infection, and discharge antibiotic prescriptions. Descriptive statistics were used.
Results:
Of the 100 patients evaluated, 11% achieved adherence with the primary outcome. Of the 89 patients who did not achieve composite outcome, only 8 selected the appropriate perioperative antibiotic. Overall, 30% were dosed appropriately, 47% were administered at the appropriate time with respect to time of incision, and 46% received perioperative antibiotics for no more than 24 hours. Also, 19 patients did not receive perioperative antibiotics. Overall, 14 different perioperative antibiotic regimens were utilized, despite institutional guidelines recommending 1 of 3 options. All 9 patients who developed nephrotoxicity received noncompliant perioperative prophylaxis. No patient developed
Clostridium difficile
infection within 30 days of surgery. Moreover, 58 patients were discharged with a prescription for at least 1 antibiotic.
Conclusions:
Most perioperative antibiotic prophylaxes for genitourinary surgeries are not compliant with institution guideline recommendations. Despite having institutional guidelines, there was a large variety in the antibiotic regimens that patients received. All of the patients identified as having an evaluated antibiotic-related adverse effect did not receive appropriate perioperative antibiotic prophylaxis. More than half of the patients received a prescription at discharge for at least 1 antibiotic.
Funding:
None
Disclosures:
None</description><subject>Antibiotics</subject><subject>Bacterial infections</subject><subject>Disease control</subject><subject>Disease prevention</subject><subject>Observational studies</subject><subject>Prophylaxis</subject><issn>0899-823X</issn><issn>1559-6834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpNkM9LwzAAhYMoOKc3_4CAVzuTpm2S4xjzB0wc6MBbSNpkZnTNTFK1_73Z5sHTu3zvPfgAuMZoghGmd7bWkxzlaEIpOQEjXJY8qxgpTsEIMc4zlpP3c3ARwgYhRDnHI_A9_5JtL6N1HXQGTrtolXXR1nDp3e5jaOWPDVB2DVy6EEPv19oP_7AAjfNw5V3r1raWLXw9IFanUkw9OK1lo7dp71k3B2Cmu6j9JTgzsg366i_HYHU_f5s9ZouXh6fZdJHVuKhIppBGDEld4JwTXiFFFS1VqahRhSpppQpZq6YpKG1M4ktUacOkUaaRiknCyRjcHHd33n32OkSxcb3v0qXIGWc5KzBhibo9UrV3IXhtxM7brfSDwEjs1YqkVuzViqSW_AJsC27I</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Drwiega, Emily</creator><creator>Rab, Saira</creator><creator>Kandiah, Sheetal</creator><creator>Kriengkauykiat, Jane</creator><creator>Wong, Jordan</creator><general>Cambridge University Press</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>S0X</scope></search><sort><creationdate>202010</creationdate><title>Evaluation of Antibiotic Prophylaxis and Postsurgery Antibiotics for Urological Surgeries at an Academic Medical Center</title><author>Drwiega, Emily ; Rab, Saira ; Kandiah, Sheetal ; Kriengkauykiat, Jane ; Wong, Jordan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1463-b0e080ae41293960b7b75b5b7fb4b576b4acbdd477df463506ef8afbfdab8a393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Antibiotics</topic><topic>Bacterial infections</topic><topic>Disease control</topic><topic>Disease prevention</topic><topic>Observational studies</topic><topic>Prophylaxis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Drwiega, Emily</creatorcontrib><creatorcontrib>Rab, Saira</creatorcontrib><creatorcontrib>Kandiah, Sheetal</creatorcontrib><creatorcontrib>Kriengkauykiat, Jane</creatorcontrib><creatorcontrib>Wong, Jordan</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>SIRS Editorial</collection><jtitle>Infection control and hospital epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Drwiega, Emily</au><au>Rab, Saira</au><au>Kandiah, Sheetal</au><au>Kriengkauykiat, Jane</au><au>Wong, Jordan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of Antibiotic Prophylaxis and Postsurgery Antibiotics for Urological Surgeries at an Academic Medical Center</atitle><jtitle>Infection control and hospital epidemiology</jtitle><date>2020-10</date><risdate>2020</risdate><volume>41</volume><issue>S1</issue><spage>s227</spage><epage>s227</epage><pages>s227-s227</pages><issn>0899-823X</issn><eissn>1559-6834</eissn><abstract>Objective:
The purpose of this study was to evaluate antibiotic use in patients undergoing urological procedures.
Methodology:
This single-center, IRB-approved, retrospective, observational study was conducted at Grady Health System. Patients were included if they underwent their first inpatient urologic procedure between April 1, 2016, and April 1, 2018. Patients were excluded if they were <18 years old, pregnant, or a prisoner. The primary outcome was percentage of overall adherence to our institutional guidelines for surgical prophylaxis as a composite of antibiotic selection, dose, preoperative timing, and postoperative duration. Secondary outcomes include individual components of the composite outcome, nephrotoxicity,
Clostridium difficile
infection, and discharge antibiotic prescriptions. Descriptive statistics were used.
Results:
Of the 100 patients evaluated, 11% achieved adherence with the primary outcome. Of the 89 patients who did not achieve composite outcome, only 8 selected the appropriate perioperative antibiotic. Overall, 30% were dosed appropriately, 47% were administered at the appropriate time with respect to time of incision, and 46% received perioperative antibiotics for no more than 24 hours. Also, 19 patients did not receive perioperative antibiotics. Overall, 14 different perioperative antibiotic regimens were utilized, despite institutional guidelines recommending 1 of 3 options. All 9 patients who developed nephrotoxicity received noncompliant perioperative prophylaxis. No patient developed
Clostridium difficile
infection within 30 days of surgery. Moreover, 58 patients were discharged with a prescription for at least 1 antibiotic.
Conclusions:
Most perioperative antibiotic prophylaxes for genitourinary surgeries are not compliant with institution guideline recommendations. Despite having institutional guidelines, there was a large variety in the antibiotic regimens that patients received. All of the patients identified as having an evaluated antibiotic-related adverse effect did not receive appropriate perioperative antibiotic prophylaxis. More than half of the patients received a prescription at discharge for at least 1 antibiotic.
Funding:
None
Disclosures:
None</abstract><cop>Cambridge</cop><pub>Cambridge University Press</pub><doi>10.1017/ice.2020.773</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Antibiotics Bacterial infections Disease control Disease prevention Observational studies Prophylaxis |
| title | Evaluation of Antibiotic Prophylaxis and Postsurgery Antibiotics for Urological Surgeries at an Academic Medical Center |
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