1449. Failure to Redose of Antibiotic Prophylaxis in Long Surgery Increases Risk of Surgical Site Infection
Session: Poster Abstract Session: HAI: Surgical Site Infections
Friday, October 28, 2016
Room: Poster Hall
  • Failure antibiotic prophylaxis_NK_IDWeek_2016.pdf (85.6 kB)
  • Background:  Antibiotic prophylaxis is a key component to prevent surgical site infection (SSI). Failure to manage antibiotic prophylaxis effectively may increase risk of SSI. This study aimed to examine the effects of antibiotic prophylaxis on SSI risk.

    Methods:  A retrospective cohort study was conducted among patients having general surgery between May 2012 and June 2016 at University of Washington Medical Center. Perioperative data extracted from hospital databases included patient and operation characteristics, intraoperative medication and fluid administration, and survival outcome. The effects of antibiotic prophylaxis and potential factors on SSI risk were estimated using multiple logistic regression and were expressed as risk ratio (RR).

    Results: A total of 4,078 patients were eligible for analysis. Of these, 180 patients were diagnosed with an SSI. Mortality rates within and after 30 days were 0.8% and 0.3%, respectively. Improper antibiotic prophylaxis redosing increased risk of SSI (RR, 4.61; 95% CI, 1.33-15.91). Other risk factors were in-patient status (RR, 4.05; 95% CI, 1.69-9.66), smoker (RR, 1.63; 95% CI, 1.03-2.55), emergency surgery (RR, 1.97; 95% CI, 1.26-3.08), colectomy (RR, 3.31; 95% CI, 1.19-9.23), pancreatectomy (RR, 4.52; 95% CI, 1.53-13.39), proctectomy (RR, 5.02; 95% CI, 1.72-14.67), small bowel surgery (RR, 6.16; 95% CI, 2.13-17.79), intraoperative blood transfusion > 500 ml (RR, 2.76; 95% CI, 1.45-5.26), and multiple procedures (RR, 1.40; 95% CI, 1.01-1.95).

    Conclusion: These data highlight that failure to redose antibiotic prophylaxis in long operations increases risk of SSI. Strengthening a collaborative surgical quality improvement program may help to eradicate this pitfall.

    Nongyao Kasatpibal, PhD1,2, Joanne D. Whitney, CWCN, FAAN, PhD, RN2, Patchen E. Dellinger, MD3, Bala G. Nair, PhD4 and Kenneth C. Pike, PhD5, (1)-, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand, (2)Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA, (3)Department of Surgery, University of Washington, Seattle, WA, (4)Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, (5)Department of Psychosocial Nursing and Community Health, School of Nursing, University of Washington, Seattle, WA


    N. Kasatpibal, None

    J. D. Whitney, None

    P. E. Dellinger, None

    B. G. Nair, None

    K. C. Pike, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.