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Successful Implementation of a Window for Routine Antimicrobial Prophylaxis Shorter than That of the World Health Organization Standard

Misteli, Heidi ; Widmer, Andreas F. ; Weber, Walter P. ; Bucher, Evelyne ; Dangel, Marc ; Reck, Stefan ; Oertli, Daniel ; Marti, Walter R. ; Rosenthal, Rachel

In: Infection Control & Hospital Epidemiology, 2012, vol. 33, no. 9, p. 912-916

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    Titre
    • Successful Implementation of a Window for Routine Antimicrobial Prophylaxis Shorter than That of the World Health Organization Standard
    Auteur
    • Misteli, Heidi. Division of General Surgery, University Hospital of Basel, Basel, Switzerland
    • Widmer, Andreas F.. Division of Infectious Disease and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
    • Weber, Walter P.. Division of General Surgery, University Hospital of Basel, Basel, Switzerland
    • Bucher, Evelyne. Division of Anesthesiology, University Hospital of Basel, Basel, Switzerland
    • Dangel, Marc. Division of Infectious Disease and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
    • Reck, Stefan. Division of General Surgery, University Hospital of Basel, Basel, Switzerland
    • Oertli, Daniel. Division of General Surgery, University Hospital of Basel, Basel, Switzerland
    • Marti, Walter R.. Division of General Surgery, Kantonsspital Aarau, Aarau, Switzerland
    • Rosenthal, Rachel. Division of General Surgery, University Hospital of Basel, Basel, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Infection Control & Hospital Epidemiology, 2012, vol. 33, no. 9, p. 912-916. Cambridge University Press
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:291113
    Summary
    Objective. To evaluate the feasibility of implementation of the refined window for routine antimicrobial prophylaxis (RAP) of 30-74 minutes before skin incision compared to the World Health Organization (WHO) standard of 0-60 minutes. Design. Prospective study on timing of routine antimicrobial prophylaxis in 2 different time periods. Setting. Tertiary referral university hospital with 30,000 surgical procedures per year. Methods. In all consecutive vascular, visceral, and trauma procedures, the timing was prospectively recorded during a first time period of 2 years (A; baseline) and a second period of 1 year (B; after intervention). An intensive intervention program was initiated after baseline. The primary outcome parameter was timing; the secondary outcome parameter was surgical site infection (SSI) rate in the subgroup of patients undergoing cholecystectomy/colon resection. Results. During baseline time period A (3,836 procedures), RAP was administered 30-74 minutes before skin incision in 1,750 (41.0%) procedures; during time period B (1,537 procedures), it was administered in 914 (56.0%; P < .001). The subgroup analysis did not reveal a significant difference in SSI rate. Conclusions. This bundle of interventions resulted in a statistically significant improvement of timing of RAP even at a shortened window compared to the WHO standard