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Anales del Sistema Sanitario de Navarra

versión impresa ISSN 1137-6627

Resumen

GIL CONESA, M et al. Evaluation of compliance with the antibiotic prophylaxis protocol in breast surgery and its effect on the incidence of surgical infection. Anales Sis San Navarra [online]. 2019, vol.42, n.2, pp.139-146.  Epub 02-Mar-2020. ISSN 1137-6627.  http://dx.doi.org/10.23938/assn.0637.

Background

Antibiotic prophylaxis is one of the most effective ways to avoid surgical site infection (SSI). The present study evaluates compliance with the antibiotic prophylaxis protocol and the effect of non-compliance on the incidence of SSI in breast surgery.

Methods

A prospective cohort study was carried out from July 2008 to July 2018. It assessed the degree of compliance with antibiotic prophylaxis in breast surgery and the causes of non-compliance: choice of antibiotic, route of administration, time of onset, dose and duration. The incidence of SSI was studied during the 30 days after intervention (90 in the case of implants or prostheses). Relative risk (RR) was used to assess the effect of inadequate prophylaxis.

Results

We studied 1,328 interventions in 1,212 women. The cumulative incidence of SSI was 1.7% (n=22) and the most common etiology was Staphylococcus aureus (47.1%). Overall antibiotic prophylaxis protocol compliance was 95.3% (including the 568 interventions where it was not indicated). The principle causes of non-compliance were the time of onset (46.8%) and choice of antibiotic (40.3%). Non-compliance significantly increased both incidence of SSI (8.1 vs 1.3%, p=0.003) and its risk (RR=6.5, CI95% 2.3-18.1).

Conclusions

The overall protocol compliance rate was very high. Non-compliance with prophylaxis protocol at least doubled the risk of SSI in breast surgery.

Palabras clave : Surgical site infection; Antibiotic prophylaxis; Breast surgery; Cohort study; Epidemiological surveillance.

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