Dual antibiotic prevention bundle is associated with decreased surgical site infections
dc.contributor.author | Kuznicki, Michelle | |
dc.contributor.author | Mallen, Adrianne | |
dc.contributor.author | McClung, Emily Clair | |
dc.contributor.author | Robertson, Sharon E. | |
dc.contributor.author | Todd, Sarah | |
dc.contributor.author | Boulware, David | |
dc.contributor.author | Martin, Stacy | |
dc.contributor.author | Quilitz, Rod | |
dc.contributor.author | Vargas, Roberto J. | |
dc.contributor.author | Apte, Sachin M. | |
dc.contributor.department | Medicine, School of Medicine | en_US |
dc.date.accessioned | 2023-01-05T14:24:22Z | |
dc.date.available | 2023-01-05T14:24:22Z | |
dc.date.issued | 2020-09 | |
dc.description.abstract | Background: Gynecologic oncology surgery is associated with a wide variation in surgical site infection risk. The optimal method for infection prevention in this heterogeneous population remains uncertain. Study design: A retrospective cohort study was performed to compare surgical site infection rates for patients undergoing hysterectomy over a 1-year period surrounding the implementation of an institutional infection prevention bundle. The bundle comprised pre-operative, intra-operative, and post-operative interventions including a dual-agent antibiotic surgical prophylaxis with cefazolin and metronidazole. Cohorts consisted of patients undergoing surgery during the 6 months prior to this intervention (pre-bundle) versus those undergoing surgery during the 6 months following the intervention (post-bundle). Secondary outcomes included length of stay, readmission rates, compliance measures, and infection microbiology. Data were compared with pre-specified one-sided exact test, Chi-square test, Fisher's exact test, or Kruskal-Wallis test as appropriate. Results: A total of 358 patients were included (178 PRE, 180 POST). Median age was 58 (range 23-90) years. The post-bundle cohort had a 58% reduction in surgical site infection rate, 3.3% POST vs 7.9% PRE (-4.5%, 95% CI -9.3% to -0.2%, p=0.049) as well as reductions in organ space infection, 0.6% POST vs 4.5% PRE (-3.9%, 95% CI -7.2% to -0.7%, p=0.019), and readmission rates, 2.2% POST vs 6.7% PRE (-4.5%, 95% CI -8.7% to -0.2%, p=0.04). Gram-positive, Gram-negative, and anaerobic bacteria were all prevalent in surgical site infection cultures. There were no monomicrobial infections in post-cohort cultures (0% POST vs 58% PRE, p=0.04). No infections contained methicillin-resistant Staphylococcus aureus. Conclusion: Implementation of a dual antibiotic infection prevention bundle was associated with a 58% reduction in surgical site infection rate after hysterectomy in a surgically diverse gynecologic oncology practice. | en_US |
dc.eprint.version | Author's manuscript | en_US |
dc.identifier.citation | Kuznicki M, Mallen A, McClung EC, et al. Dual antibiotic prevention bundle is associated with decreased surgical site infections. Int J Gynecol Cancer. 2020;30(9):1411-1417. doi:10.1136/ijgc-2020-001515 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/30847 | |
dc.language.iso | en_US | en_US |
dc.publisher | BMJ | en_US |
dc.relation.isversionof | 10.1136/ijgc-2020-001515 | en_US |
dc.relation.journal | International Journal of Gynecological Cancer | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | PMC | en_US |
dc.subject | Gynecologic surgical procedures | en_US |
dc.subject | Gynecology | en_US |
dc.subject | Laparotomy | en_US |
dc.subject | Postoperative complications | en_US |
dc.subject | Surgical wound infection | en_US |
dc.title | Dual antibiotic prevention bundle is associated with decreased surgical site infections | en_US |
dc.type | Article | en_US |