Opportunities for system level improvement in antibiotic use across the surgical pathway
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Optimizing antibiotic prescribing across the surgical pathway (before, during, and after surgery) is a key aspect of tackling important drivers of antimicrobial resistance and simultaneously decreasing the burden of infection at the global level. In the UK alone, 10 million patients undergo surgery every year, which is equivalent to 60% of the annual hospital admissions having a surgical intervention. The overwhelming majority of surgical procedures require effectively limited delivery of antibiotic prophylaxis to prevent infections. Evidence from around the world indicates that antibiotics for surgical prophylaxis are administered ineffectively, or are extended for an inappropriate duration of time postoperatively. Ineffective antibiotic prophylaxis can contribute to the development of surgical site infections (SSIs), which represent a significant global burden of disease. The World Health Organization estimates SSI rates of up to 50% in postoperative surgical patients (depending on the type of surgery), with a particular problem in low- and middle-income countries, where SSIs are the most frequently reported healthcare-associated infections. Across European hospitals, SSIs alone comprise 19.6% of all healthcare-acquired infections. Much of the scientific research in infection management in surgery is related to infection prevention and control in the operating room, surgical prophylaxis, and the management of SSIs, with many studies focusing on infection within the 30-day postoperative period. However it is important to note that SSIs represent only one of the many types of infection that can occur postoperatively. This article provides an overview of the surgical pathway and considers infection management and antibiotic prescribing at each step of the pathway. The aim was to identify the implications for research and opportunities for system improvement.
Date Issued
2017-05-05
Date Acceptance
2017-04-25
Citation
International Journal of Infectious Diseases, 2017, 60, pp.29-34
ISSN
1201-9712
Publisher
Elsevier
Start Page
29
End Page
34
Journal / Book Title
International Journal of Infectious Diseases
Volume
60
Copyright Statement
© 2017 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access
article under the CC-BY-NC-ND license
(http://creativecommons.org/licenses/by-
nc-nd/4.0/).
article under the CC-BY-NC-ND license
(http://creativecommons.org/licenses/by-
nc-nd/4.0/).
Sponsor
National Institute for Health Research
National Institute for Health Research
National Institute for Health Research
National Institute for Health Research
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000405489800006&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
HPRU-2012-10047
HPRU-2012-10047
KMRF-2015-04-007
KMRF-2015-04-007
Subjects
Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Surgery
Infection
Antibiotic prescribing
Low and middle income countries
CARE-ASSOCIATED INFECTIONS
URINARY-TRACT-INFECTION
SITE INFECTION
RISK-FACTORS
POSTOPERATIVE PNEUMONIA
SAFETY CHECKLISTS
ENHANCED-RECOVERY
OPERATING-ROOM
SURGERY
OUTCOMES
Publication Status
Published