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CP-070 The impact of hospital antibiotic guidelines on surgical prophylaxis in paediatric patients suffering upper and lower extremity injuries
  1. I Sviestina1,
  2. D Mozgis2
  1. 1University Children’s Hospital, Riga, Latvia
  2. 2Riga Stradins University, Public Health and Epidemiology Department, Riga, Latvia

Abstract

Background Surgical prophylaxis may account for 1/3 of all antibiotic use in paediatric hospitals and 80% of all antibiotic use in surgery. Appropriate surgical antimicrobial prophylaxis can prevent post-operative infection of the surgical site.

Purpose To evaluate antibiotic use for surgical prophylaxis in paediatric patients suffering upper and lower extremity injuries.

Material and methods Retrospective review of patients’ medicines records before guidelines introduction in July/August and two months after in November/December 2013. Comparative analysis of the appropriateness of prophylaxis: number and percentage of patients who got prophylaxis on time, correct antibiotic dose and duration of prophylaxis.

Results Total number of patients: 201 in July/August and 81 in November/December. Prophylaxis was needed for 94 (47%) patients in July/August and 53 (65%) in November/December. 14 (15%) in July/August and 16 (30%) patients in November/December didn’t receive prophylaxis although it was indicated in the guidelines.

Prophylaxis was too early in 13 (16%) patients in July/August, 9 (24%) in November/December; on time: 40 (50%) in July/August and 17 (46%) in November/December, too late (started during or after surgery): 21 (26%) in July/August, 10 (27%) in November/December. No information about time: 6 (7%) in July/August, 1 (3%) November/December.

64 (87%) patients received a single dose in July/August and 32 (86%) in November/December; multiple doses within 24 h: 6 (8%) patients in July/August and 1 (3%) in November/December; prophylaxis >1 day: 7 (9%) patients in July/August and 4 (11%) in November/December.

Cefazolin dose was too low in 16/79 (20%) patients in July/August and 3/37 (8%) patients in November/December.

Conclusion Although the guidelines were discussed and accepted by surgeons and there had been a two-month introduction period as well, only low positive trends were observed, with antibiotic treatment guidelines not having a major impact on antibiotic use. There is a need for new ways of promoting adherence to guidelines and appropriate antibiotic use.

References and/or Acknowledgements No conflict of interest.

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