Impact of an Antimicrobial Stewardship Program on Surgical Antibiotic Prophylaxis Conformity According to 2013 ASHP/IDSA Guidelines
Bibliographic record
Abstract
Background. Surgical site infections (SSI) represent a significant complication of surgery by increasing costs, length of stay, and mortality. Although surgical antimicrobial prophylaxis (SAP) decreases SSI, adherence to guidelines is often variable. We assessed the effect of persuasive interventions, delivered by an antimicrobial stewardship program (ASP), on SAP global conformity improvement according to clinical guidelines. Methods. A multicenter, quasi-experimental study was performed, assessing global SAP conformity pre- and post- persuasive interventions delivered by ASP for nine different surgical services (general surgery, thoracic, cardiac, vascular, hepatobiliary/graft, orthopedic, obstetrics and gynecology, urology, and neurology). Pre- and post-intervention data were collected retrospectively using patients' files from April 2012 to March 2013 and from March 2014 to June 2014, respectively, to assess the effect of persuasive interventions delivered by ASP on SAP global conformity score based on choice of agent, dose, timing and prophylaxis duration, and to verify whether conformity varies between surgical services and aforementioned SAP criteria. Results. 1585 audited surgeries were included in the primary analysis. The global conformity score pre-intervention was 62.4% and increased to 77.6% post-intervention (p < 0.001). This difference remained statistically significant with sub-analysis per criterion, except for timing and readministration. A statistically significant difference was also observed in global conformity for all surgical services except urology, vascular, and obstetrics and gynecology. In the multivariate analysis, improvement in SAP conformity remained similar, accounting for potential confounders—notably sex, type of surgery (elective or urgent), the American Society of Anesthesiologists (ASA) score, duration of surgery, surgical service, methicillin-resistant Staphylococcus aureus, and allergy. Conclusion. For surgical antimicrobial prophylaxis, changes in practice occur best through an antimicrobial stewardship program. Persuasive interventions delivered through an antimicrobial stewardship to the surgical team, including a collaborative publication of internal guidelines, improves surgical antimicrobial prophylaxis prescription. Disclosures. All authors: No reported disclosures.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".