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- W2894968986 abstract "Introduction: Following an audit and detailed analysis of the microflora of surgical site infections (SSIs) after pancreatoduodenectomy (PD), the local antibiotic policy was changed based on sensitivities. The aim of the current study was to analyse the results of a change in prescribing policy on SSI rates and on the occurrence and severity of postoperative pancreatic fistulae (POPF). Methods: A prospectively maintained departmental database was used to identify 200 consecutive patients undergoing PD, 100 pre- and 100 post institution of policy change. Incidence data relating to SSIs and POPF were obtained from the NSQIP data set and the details of culture results and organism sensitivity extracted from the electronic medical record, as were details on the severity of fistulae. Results: Following change of antibiotics from Cefalexin to Cefrtiaxone and Metronidzole the SSI rate fell from 29% to 16% (p=0.04). After excluding patients with a penicillin allergy (n=11), and comparing those adherent (53/89) and non-adherent (36/89), the SSI rates were 7.5% vs. 27.8% (p=0.02), the alter being comparable to the 29% in the pre-policy cohort. The overall incidence of POPF fell from 37% to 24% (P=0.04), and the rate of clinically significant fistula from 24% to 9% (p=0.03). Conclusions: A change in antibiotic policy based on the local microflora resulted in a significant reduction in the SSI rates, and also resulted in a reduction in the overall incidence as well as the incidence of clinically-significant POPF. Following further education on adherence to the policy a re-audit is in process." @default.
- W2894968986 created "2018-10-12" @default.
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- W2894968986 date "2018-09-01" @default.
- W2894968986 modified "2023-09-30" @default.
- W2894968986 title "Antimicrobial stewardship reduces SSI rate, number and severity of pancreatic fistulae following pancreatoduodenectomy" @default.
- W2894968986 doi "https://doi.org/10.1016/j.hpb.2018.06.324" @default.
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