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ArticleHealth science reports2026

Adherence to Surgical Antimicrobial Prophylaxis Guidelines and Improvement Efforts: A Single-Center, Pre- and Post-Intervention Comparison Study.

Chie Yamamoto, Yoko Nukui, Tadashi Kosaka, Kazuhiro Aoto, Rina Kozen, Kayo Hasegawa, Chikae Ota, Yuki Inoue, Masashi Taniguchi, Ryosuke Hamashima and 6 more

Abstract read
In one paragraph

Article in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

1 citing paper in PubMed.

  1. Article
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

16 authors.

Chie YamamotoDepartment of Infection Control and Laboratory Medicine Kyoto Prefectural University of Medicine Kyoto Japan.ORCID https://orcid.org/0000-0002-3919-8830
Yoko NukuiDepartment of Infection Control and Laboratory Medicine Kyoto Prefectural University of Medicine Kyoto Japan.
Tadashi KosakaDepartment of Pharmacy, University Hospital Kyoto Prefectural University of Medicine Kyoto Japan.
Kazuhiro AotoDepartment of Pharmacy, University Hospital Kyoto Prefectural University of Medicine Kyoto Japan.
Rina KozenDepartment of Pharmacy, University Hospital Kyoto Prefectural University of Medicine Kyoto Japan.
Kayo HasegawaCentral Surgical Unit/Local Anesthesia Surgery Center Kyoto Prefectural University of Medicine Kyoto Japan.
Chikae OtaCentral Surgical Unit/Local Anesthesia Surgery Center Kyoto Prefectural University of Medicine Kyoto Japan.
Yuki InoueCentral Surgical Unit/Local Anesthesia Surgery Center Kyoto Prefectural University of Medicine Kyoto Japan.
Masashi TaniguchiDepartment of Infectious Disease Kyoto City Hospital Kyoto Japan.
Ryosuke HamashimaDepartment of Infection Control and Laboratory Medicine Kyoto Prefectural University of Medicine Kyoto Japan.
Keitaro FurukawaDepartment of Infection Control and Laboratory Medicine Kyoto Prefectural University of Medicine Kyoto Japan.
Keisuke KikuchiDepartment of Infection Control, University Hospital Kyoto Prefectural University of Medicine Kyoto Japan.
Ayami NakanishiDepartment of Infection Control, University Hospital Kyoto Prefectural University of Medicine Kyoto Japan.
Satoshi TeramukaiDepartment of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan.ORCID https://orcid.org/0000-0003-2184-0597
Yasuhiko HoriiDepartment of Anesthesiology Kyoto Prefectural University of Medicine Kyoto Japan.
Teiji SawaDepartment of Anesthesiology Kyoto Prefectural University of Medicine Kyoto Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: Adherence to surgical antimicrobial prophylaxis (SAP) guidelines reduces the incidence of surgical site infections (SSIs) and improves prognosis and healthcare economics. This single-center, pre- and post-intervention comparative study investigated SAP guidelines adherence. Accordingly, we intervened where improvements were required. Changes in SAP guidelines adherence and SSI incidence were then evaluated. Methods: We assessed adherence to the appropriate antimicrobial administration timing within 1 h before skin incision in surgeries performed between April 2021 and June 2022. Regarding drug selection, dosage, and duration, we evaluated SAP protocols for 228 procedures across 18 departments and compared them with established guidelines. Results: Overall adherence to appropriate antimicrobial administration timing was 92.3% (4687/5076). Adherence was particularly low after gastroenterological surgery, cardiovascular surgery, orthopedic surgery, and neurosurgery, with a total adherence rate of 82.6% (1603/1941) across these four departments. Drug selection and duration deviated from guidelines in 25% (57/228) of procedures. The most common area requiring improvement was inappropriate drug selection in 57.9% (33/57), followed by unnecessarily long duration in 50.9% (29/57) of cases. In addition to an educational approach, a new antimicrobial initiation index, based on preoperative preparatory events, was established in low-adherence departments. All protocols requiring improvement were revised to align with established guidelines. Consequently, adherence to the appropriate antimicrobial administration timing in departments with previously low adherence improved significantly (pre-intervention: 82.6%; 95% confidence interval [CI]: 80.8%-84.2%; post-intervention: 95.0%; 95% CI: 93.8%-96.0%; Conclusion: Establishing department-specific antimicrobial initiation indexes, based on the surgical preparation stage, might be an effective measure for improving adherence to the appropriate antimicrobial administration timing in patients receiving SAP. Changes in SSI incidence require further study.

Indexed as

antibacterial agentsantimicrobial stewardshipsurgical antimicrobial prophylaxissurgical site infections

Identifiers

PMID41509060
PMCPMC12779008

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