Evaluation after implementation of chemical bowel preparation for surgical site infections in elective colorectal cancer surgery and role of antimicrobial stewardship pharmacist: Retrospective cohort study

Yasuhiro Sasaki; Akira Kurishima; Chieko Miyamoto; Kenichiro Hataji; Toru Tezuka; Hideo Katsuragawa

doi:10.1186/s40780-024-00333-1

Evaluation after implementation of chemical bowel preparation for surgical site infections in elective colorectal cancer surgery and role of antimicrobial stewardship pharmacist: Retrospective cohort study

J Pharm Health Care Sci. 2024 Feb 19;10(1):11. doi: 10.1186/s40780-024-00333-1.

Authors

Yasuhiro Sasaki¹, Akira Kurishima², Chieko Miyamoto³, Kenichiro Hataji⁴, Toru Tezuka⁵, Hideo Katsuragawa⁴

Affiliations

¹ Department of Pharmacy, Tama-Nambu Chiiki Hospital, Tokyo Metropolitan Organization, 1-2, Nakazawa 2-Chome, Tama, Tokyo, 206-0036, Japan. yasuhiro_sasaki@tmhp.jp.
² Division of Public Health, Teikyo University Graduate School of Public Health, 2-11, Kaga 1-Chome, Itabashi-ku, Tokyo, 173-8605, Japan.
³ Department of Nursing, Tama-Nambu Chiiki Hospital, Tokyo Metropolitan Organization, 1-2, Nakazawa 2-Chome, Tama, Tokyo, 206-0036, Japan.
⁴ Department of Surgery, Tama-Nambu Chiiki Hospital, Tokyo Metropolitan Organization, 1-2, Nakazawa 2-Chome, Tama, Tokyo, 206-0036, Japan.
⁵ Department of Endoscopy, Tama-Nambu Chiiki Hospital, Tokyo Metropolitan Organization, 1-2, Nakazawa 2-Chome, Tama, Tokyo, 206-0036, Japan.

Abstract

Background: We evaluated the predictive factors for surgical site infections (SSIs) in elective colorectal cancer surgery and the role of antimicrobial stewardship (AS) pharmacists in modifying the clinical pathway.

Main body: Between February 2017 and January 2022, 414 elective colorectal cancer surgeries were performed. The results of multivariate analysis by SSI incidence were adjusted odds ratio (aOR): 0.45; 95% confidence interval (CI): 0.22-0.96 (P = 0.039) for sex (female), aOR: 0.27; 95% CI: 0.13-0.58 (P < 0.001) for laparoscopy, aOR: 0.42; 95% CI: 0.19-0.91 (P = 0.029) for chemical bowel preparation. The median (interquartile range) postoperative length of stay was 12 (10.0-18.5) vs. 10 (9.0-13.0) days before and after the clinical pathway was modified (P < 0.001).

Conclusion: The role of AS pharmacists was primarily to conduct a literature search to explore whether SSIs could be ameliorated by pharmacotherapy, coordinate the addition of chemical bowel preparation, and epidemiologically confirm their effectiveness.

Keywords: Antimicrobial stewardship pharmacist; CHEMICAL bowel preparation; Surgical site infection.