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Successful Implementation of a Window for Routine Antimicrobial Prophylaxis Shorter than That of the World Health Organization Standard

Heidi Misteli MD, Andreas F. Widmer MD MS, Walter P. Weber MD, Evelyne Bucher MD, Marc Dangel MPH RN, Stefan Reck MD, Daniel Oertli MD FACS, Walter R. Marti MD FACS and Rachel Rosenthal MD
Infection Control and Hospital Epidemiology
Vol. 33, No. 9 (September 2012), pp. 912-916
DOI: 10.1086/667374
Stable URL: http://www.jstor.org/stable/10.1086/667374
Page Count: 5
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Successful Implementation of a Window for Routine Antimicrobial Prophylaxis Shorter than That of the World Health Organization Standard
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Abstract

Objective. To evaluate the feasibility of implementation of the refined window for routine antimicrobial prophylaxis (RAP) of 30–74 minutes before skin incision compared to the World Health Organization (WHO) standard of 0–60 minutes.Design. Prospective study on timing of routine antimicrobial prophylaxis in 2 different time periods.Setting. Tertiary referral university hospital with 30,000 surgical procedures per year.Methods. In all consecutive vascular, visceral, and trauma procedures, the timing was prospectively recorded during a first time period of 2 years (A; baseline) and a second period of 1 year (B; after intervention). An intensive intervention program was initiated after baseline. The primary outcome parameter was timing; the secondary outcome parameter was surgical site infection (SSI) rate in the subgroup of patients undergoing cholecystectomy/colon resection.Results. During baseline time period A (3,836 procedures), RAP was administered 30–74 minutes before skin incision in 1,750 (41.0%) procedures; during time period B (1,537 procedures), it was administered in 914 (56.0%; ). The subgroup analysis did not reveal a significant difference in SSI rate.Conclusions. This bundle of interventions resulted in a statistically significant improvement of timing of RAP even at a shortened window compared to the WHO standard.

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