AB054. SOH24AB_242. Quality improvement in surgical antibiotic prophylaxis: a systematic review and meta-analysis assessing the impact of a surgeon’s role
Systematic Review Session

AB054. SOH24AB_242. Quality improvement in surgical antibiotic prophylaxis: a systematic review and meta-analysis assessing the impact of a surgeon’s role

Katie Giblin1, Gavin Calpin2, Gavin Dowling1, Sandra Hembrecht1

1Department of Postgraduate Studies, Royal College of Surgeons in Ireland, Dublin, Ireland; 2Department of Surgery, Beaumont Hospital, Beaumont, Dublin, Ireland

Background: Despite research highlighting the importance of surgical antimicrobial prophylaxis (SAP) in surgical site infection (SSI) prevention, compliance with guidelines remains problematic. In point prevalence surveys, across Ireland and Europe, SSI remains one of the most common healthcare associated infections. Quality improvement (QI) initiatives to tackle this have been reported. Historically these initiatives are led by either pharmacists or infection specialists. The aim of this study is to establish the impact of a surgeon’s involvement in SAP quality initiatives.

Methods: A systematic review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Articles were included if they assessed QI activities to improve compliance with SAP guidelines. Data were collected on the role of the first author, affiliated institutes of all authors and compliance with SAP guidance pre and post QI intervention. Meta-analysis and meta-regression were then conducted.

Results: A total of 71 articles were selected for systematic review. Surgical departments were not listed as any author’s affiliated institute in 67.6% of published studies (48/71). First authorship affiliation was reported to be a surgical department in 23.9% (17/71), a pharmacy department in 21.1% (15/71) and an anaesthetic department in 19.7% (14/71). Forty-one articles were included for meta-analysis. Regardless of first author affiliation, meta-analysis found any QI intervention had a favourable impact on overall compliance with SAP versus no intervention [odds ratio (OR): 0.21, 95% confidence interval (CI): 0.20–0.22].

Conclusions: QI produces favourable change in SAP practices. A low proportion of publications in the area are reported as having a surgeon’s involvement. Further work is required, with greater involvement from all stakeholders to impact change.

Keywords: Meta-analysis; systematic review; quality improvement (QI); surgical antibiotic prophylaxis; surgical site infection (SSI)

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab054
Cite this abstract as: Giblin K, Calpin G, Dowling G, Hembrecht S. AB054. SOH24AB_242. Quality improvement in surgical antibiotic prophylaxis: a systematic review and meta-analysis assessing the impact of a surgeon’s role. Mesentery Peritoneum 2024;8:AB054.

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