Top

European Archives of Oto-Rhino-Laryngology

Published in:

01-09-2008 | Miscellaneous

Using information technology to reduce the inappropriate use of surgical prophylactic antibiotic

Authors: Shih-An Liu, Yung-Tsung Chiu, Whe-Dar Lin, Shu-Jan Chen

Published in: European Archives of Oto-Rhino-Laryngology | Issue 9/2008

Abstract

Despite implementation of practical guidelines, continuing education programs in our hospital, the percentage of inappropriate prophylactic antibiotic usage remains high. The aim of this study was to investigate whether information technology can reduce the misuse of surgical prophylactic antibiotic. We started physician continuing education programs in January 2005 and initiated feedback system in July 2005. The computerized reminder system was implemented in April 2006. Relevant data about the surgical prophylactic antibiotic usage were collected and was separated into three groups. Group 1 consisted of data from January 2005 to June 2005, while group 2 and group 3 consisted of data from July 2005 to March 2006 and April 2006 to December 2006, respectively. The percentage of no prophylactic antibiotic in clean procedures and the duration of prophylactic antibiotic in clean-contaminated procedures were recorded and analyzed. Furthermore, the surgical wound infection rates were also collected. In clean procedures, the percentage of no prophylactic antibiotic after surgery decreased in the long run. In parotidectomy, submandibular gland surgery and thyroidectomy patients, the percentage even reached 100% at the end of this study. In clean-contaminated procedures, the duration of prophylactic antibiotic after surgery was also reduced except in laryngectomized patients at the end of this study. Information technology such as feedback and reminder systems is an effective method to reduce inappropriate usage of surgical prophylactic antibiotic.

McDonald LC, Yu HT, Yin HC, Hsiung AC, Ho M; Antibiotic Use Working Group (2001) Use and abuse of surgical antibiotic prophylaxis in hospitals in Taiwan. J Formos Med Assoc 100:5–13PubMed

Ramsay C, Brown E, Hartman G, Davey P (2003) Room for improvement: a systemic review of the quality of evaluations of interventions to improve hospital antibiotic prescribing. J Antimicrob Chemother 52:764–771PubMedCrossRef

Davey P, Brown E, Fenelon L, Finch R, Gould I, Hartman G, Holmes A, Ramsay C, Taylor E, Wilcox M, Wiffen P (2005) Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev (4):CD003543 Review

Harrison JW, Svec TA (1998) The beginning of the end of the antibiotic era? Part I. The problem: abuse of the “miracle drugs”. Quintessence Int 29:151–162PubMed

Harrison JW, Svec TA (1998) The beginning of the end of the antibiotic era? Part II. Proposed solutions to antibiotic abuse. Quintessence Int 29:223–229PubMed

Kawamoto K, Houlihan CA, Balas EA, Lobach DF (2005) Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ 330:765PubMedCrossRef

Guidelines for the use of prophylactic antibiotics in surgery in Taiwan. (2004) J Microbiol Immunol Infect 37:71–74

Knight R, Charbonneau P, Ratzer E, Zeren F, Haun W, Clark J (2001) Prophylactic antibiotics are not indicated in clean general surgery cases. Am J Surg 182:682–686PubMedCrossRef

Belongia EA, Schwartz B (1998) Strategies for promoting judicious use of antibiotics by doctors and patients. BMJ 317:668–671PubMed

10.

Patel VL, Currie LM (2005) Clinical cognition and biomedical informatics: issues of patient safety. Int J Med Inform 74:869–885PubMedCrossRef

11.

Sibley JC, Sackett DL, Neufeld V, Gerrard B, Rudnick KV, Fraser W (1982) A randomized trial of continuing medical education. N Engl J Med 306:511–515PubMedCrossRef

12.

Lewis CE, Hassanein RS (1970) Continuing medical education—an epidemiologic evaluation. N Engl J Med 282:254–259PubMedCrossRef

13.

Seven H, Sayin I, Turgut S (2004) Antibiotic prophylaxis in clean neck dissections. J Laryngol Otol 118:213–216PubMedCrossRef

14.

Davis DA, Taylor-Vaisey A (1997) Translating guidelines into practice. A systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. CMAJ 157:408–416PubMed

15.

Rodrigo JP, Alvarez JC, Gomez JR, Suarez C, Fernandez JA, Martinez JA (1997) Comparison of three prophylactic antibiotic regimens in clean-contaminated head and neck surgery. Head Neck 19:188–193PubMedCrossRef

16.

Cloke DJ, Green JE, Khan AL, Hodgkinson PD, McLean NR (2004) Factors influencing the development of wound infection following free-flap reconstruction for intra-oral cancer. Br J Plast Surg 57:556–560PubMedCrossRef

17.

Penel N, Fournier C, Lefebvre D, Lefebvre JL (2005) Multivariate analysis of risk factors for wound infection in head and neck squamous cell carcinoma surgery with opening of mucosa. Study of 260 surgical procedures. Oral Oncol 41:294–303PubMedCrossRef

18.

Righi M, Manfredi R, Farneti G, Pasquini E, Cenacchi V (1996) Short-term versus long-term antimicrobial prophylaxis in oncologic head and neck surgery. Head Neck 18:399–404PubMedCrossRef

19.

Carroll WR, Rosenstiel D, Fix JR, de la Torre J, Solomon JS, Brodish B, Rosenthal EL, Heinz T, Niwas S, Peters GE (2003) Three-dose vs extended-course clindamycin prophylaxis for free-flap reconstruction of the head and neck. Arch Otolaryngol Head Neck Surg 129:771–774PubMedCrossRef

Title: Using information technology to reduce the inappropriate use of surgical prophylactic antibiotic
Authors: Shih-An Liu
Yung-Tsung Chiu
Whe-Dar Lin
Shu-Jan Chen
Publication date: 01-09-2008
Publisher: Springer-Verlag
Published in: European Archives of Oto-Rhino-Laryngology / Issue 9/2008
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-008-0588-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Using information technology to reduce the inappropriate use of surgical prophylactic antibiotic

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 9/2008

Bilateral submandibular duct relocation by high-frequency radiosurgery

Piezosurgery in the exeresis of glomus tympanicum tumours

Analysis of manual segmentation in paranasal CT images

Multifrequency tympanometry in adults with otitis media with effusion

Accessory parotid gland lesions: case report and review of literature

Reply to the letter to the editor by Lucioni and Marioni: “Clinically based comments on the proposal for revision of the European Laryngological Society (ELS) classification of endoscopic cordectomies”