Evidence map›Paper›PMID 34706755›Full record

ArticlePatient safety in surgery2021

Variation in practice for preoperative antibiotic prophylaxis: a survey from an academic tertiary referral center in the United States.

Nikhil Ailaney, Elizabeth Zielinski, Michelle Doll, Gonzalo M Bearman, Stephen L Kates, Gregory J Golladay

Abstract read
In one paragraph

Article in Patient safety in surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Nikhil AilaneyDepartment of Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, 1200 Broad Street, 9th Floor, VA, 23298, Richmond, USA. nikhil_ailaney@urmc.rochester.edu.ORCID http://orcid.org/0000-0003-2309-6909
Elizabeth ZielinskiDepartment of Orthopaedic Surgery, Virginia Commonwealth University Health, VA, 23298, Richmond, USA.
Michelle DollDepartment of Infectious Disease, Virginia Commonwealth University Health, VA, 23298, Richmond, USA.
Gonzalo M BearmanDepartment of Infectious Disease, Virginia Commonwealth University Health, VA, 23298, Richmond, USA.
Stephen L KatesDepartment of Orthopaedic Surgery, Virginia Commonwealth University Health, VA, 23298, Richmond, USA.
Gregory J GolladayDepartment of Orthopaedic Surgery, Virginia Commonwealth University Health, VA, 23298, Richmond, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntibiotic surgical prophylaxis is a core strategy for prevention of surgical site infections (SSI). Despite best practice guidelines and known efficacy of antibiotic prophylaxis in decreasing SSI risk, there is often wide variation in its use. This study was designed to determine the individual perspectives of perioperative providers at an academic tertiary referral center regarding their knowledge of preoperative antibiotic choice, dosing, and timing.

methodsA prospective survey was conducted amongst surgical and anesthesia team members involved in preoperative antibiotic decision making. The survey addressed ten key principles relating to preoperative antibiotic use, including antibiotic choice, timing and rate of infusion, and dosing. The survey was distributed among orthopaedic surgeons, residents, and anesthesia providers at their respective monthly service line meetings between August 2017 to June 2019. The data was stored and analyzed in a Microsoft Excel worksheet.

resultsA total of 73 providers completed the survey. Twenty-two (30 %) of the providers agreed and 47 (64 %) disagreed that both vancomycin and cefazolin are equally effective for antibiotic prophylaxis. As for antibiotic choice in patients with penicillin allergies, 37 (51 %) agreed with vancomycin, 21 (29 %) agreed with clindamycin, and 15 (21 %) disagreed with both alternatives. When providers were surveyed regarding the appropriateness of standard versus weight adjusted dosing, 67 (92 %) agreed that vancomycin should be weight adjusted and 63 (86 %) agreed that cefazolin should be weight adjusted.

conclusionsThere is no clear consensus amongst providers for which antibiotic to administer for antibiotic prophylaxis despite existing guidelines. Discrepancy also exists between orthopaedic surgery and anesthesia providers in regards to appropriate antibiotic choice for patients with reported penicillin allergies. Institutions should implement evidence-based protocols for preoperative antibiotic prophylaxis and continue to prospectively monitor compliance in order to identify any inconsistencies that could result in inappropriate antibiotic prophylaxis for patients.

Indexed as

Antibiotic prophylaxisOrthopaedic surgeryQuality improvementSurgical site infection

Identifiers

PMID34706755
PMCPMC8549297

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.