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KMID : 1147420210060010028
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Journal of Surgical Infection
2021 Volume.6 No. 1 p.28 ~ p.35
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Analysis of Prophylactic Antibiotics Usage Time to Prevent Surgical Site Infection
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Nam Soo-Min
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Abstract
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Objectives: Prophylactic antibiotics (PA) are used to prevent surgical site infection (SSI). However, inadequate use of antibiotics increases medical costs by increasing SSI, and antibiotic resistance due to misuse of antibiotics. Health Insurance Review and Assessment Service (HIRA) is currently evaluating the adequacy of PA for surgery. The aim of this study is to evaluate veritable duration of PA during non-evaluation period by HIRA.
Methods: Patients who underwent surgery from October to December 2017 were included. The 19 types of surgery which are the targets for Surgical Prophylactic Antibiotics Usage Evaluation of HIRA were included. Duration from preoperative PA administration to the last administration was evaluated.
Results: The total 1,009 patients were included in the study and 251 (24.9%) patients were excluded. Among 758 patients, 480 (63.3%) discontinued antibiotics within 24 hours. Some types of surgery promised to administer antibiotics longer than 24 hours depending on the characteristics of the surgery. Considering this promised period, 422 (91.3%) patients discontinued the administration within agreed duration. 67 patients (8.8%) had long-term antibiotics administration, and most of them required antibiotic treatment due to postoperative fever, SSI, and pneumonia. In 21 patients (2.7%), long-term antibiotics were administered due to a prescription error without any special reason.
Conclusion: Adequate duration of PA were administrated to 91.2% of patients. A study on the appropriateness of long term administration in some types of surgery will be needed. Antibiotics were unnecessarily administered for a long time due to prescription error in 2.7%. The system improvement is need to reduce prescription error.
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KEYWORD
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Anti-bacterial agents, Surgical wound infection, Antimicrobial stewardship
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