[Incidence of surgical site infection in colon surgery and antibiotic prophylaxis adequacy: prospective cohort study]

An Sist Sanit Navar. 2017 Dec 29;40(3):371-377. doi: 10.23938/ASSN.0045.
[Article in Spanish]

Abstract

Background: Surgical site infection (SSI) has a considerable clinical and economic impact at the hospital level, so prevention and monitoring are considered a high priority. The objective of this study was to assess compliance with the protocol of antibiotic prophylaxis in colon surgery and the effect of its inadequacy for the incidence of SSI.

Methods: Prospective cohort study from July 2008 to July 2016. Compliance with antibiotic prophylaxis protocol and the causes of non-compliance were evaluated in colon surgery: duration and starting, choice, route of administration and dose of the antibiotic. The incidence of SSI was studied after a maximum incubation period of 30 days. Relative risk (RR) was used to evaluate the non-compliance causes of prophylaxis.

Results: The study included 771 patients. The cumulative incidence of SSI was 5.8% (n=45), of which 2/3 were superficial incisional infections. The most common cause of SSI was Escherichia coli (28%). Antibiotic prophylaxis was administered in 97.8% of patients, with an overall protocol compliance of 91.9%. The principle cause of non-compliance was the choice of antibiotic (58.2%). No relationship between the inadequacy of prophylaxis and incidence of surgical site infection was found (RR=0.5; CI95% 0.1-1.8).

Conclusions: The overall adequacy rate to antibiotic prophylaxis protocol was high. No significant association between the adequacy of prophylaxis and incidence of surgical site infection in colon surgery was found.

MeSH terms

  • Aged
  • Antibiotic Prophylaxis / standards*
  • Cohort Studies
  • Colon / surgery*
  • Digestive System Surgical Procedures*
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Incidence
  • Male
  • Prospective Studies
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / prevention & control*