5PSQ-024 Analysis of the use of perioperative antibiotic prophylaxis

<h3>Background and Importance</h3> Surgical injury infections occur in incision/nearby-areas, during the first 30–90 days post-operation. The administration of appropriate antibiotics perioperatively can prevent these infections (effectiveness 18–81%). Surgical prophylaxis accounts 30–50% antibiotic use in surgical services, so updating-monitoring protocols is a priority measure to improve antibiotic use by PROA teams. To analyse perioperative antibiotic prophylaxis prescriptions to determine if they adapt to current local-protocols. <h3>Aim and Objectives</h3> To analyse perioperative antibiotic prophylaxis prescriptions to determine if they adapt to current local-protocols. <h3>Material and Methods</h3> Prospective observational study (May to December´2023) in a second-level hospital. Inclusion criteria: surgical interventions in inpatient surgery regimen. <h3>Variables:</h3> Age-gender. Adverse drug reactions (ADR). Surgical area. Type of surgery. Intervention procedure. Antibiotic prophylaxis: compliance with local protocol and discrepancies found. Exclusion criteria: outpatient surgery interventions. Data were obtained from electronic medical record. Collected-analysed in Excel. <h3>Results</h3> 200 patients were included, 130 patients were men, median age 60 years (IQR 49–71). 7 patients with ADRs: four were allergic to antibiotics (three penicillins, one quinolones). One patient was given an alternative antibiotic. The rest needed no further adjustment. Major surgical areas: General Surgery Digestive System 110 interventions, Urology 48 and Otorhinolaryngology 20. Minor areas: Traumatology 12 interventions, Ophthalmology six, Maxillofacial Surgery three and Vascular Surgery 1. Type of surgery: 89 clean, 68 clean-contaminated, 27 clean-contaminated/potentially-contaminated, five others, four contaminated and three clean with implants. Four cases not stated in protocol. Majority intervention procedures: 33 hernioplasties, 26 transurethral-resection prostate/bladder, 16 cholecystectomies, 14 colon-rectum-distal-ileum surgeries, 12 amidalectomies-adenidectomies-septoplasties, 11 appendectomies, 11 thyroidectomies-paraidectomies, 10 breast-surgeries and six vitrectomies. Antibiotic prophylaxis used in 146 patients complied with local protocol, 50 did not comply and it could not be determined in four patients. Main discrepancies: prescribing another antimicrobial agent than in the protocol in 15 cases, prescribing an antimicrobial agent in patients who did not meet risk factors for administration in 11, using an alternative protocol regimen in patients not allergic to drug of choice in nine, patients who met risk factors for administration and were not prescribed antibiotic prophylaxis in eight and inadequate duration in seven cases. The majority of discrepancies were found in clean-interventions. <h3>Conclusion and Relevance</h3> Monitoring perioperative antibiotic prophylaxis guidelines is key to determine if whether the current local protocol is being followed. Also to consider if it needs to be re-evaluated and updated with PROA team. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest