Administrative MDT interventions reduced prophylactic antibiotic use in Class I incisions across three study phases.
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Key Takeaway
Consider administrative MDT interventions to reduce prophylactic antibiotic use in Class I incisions, noting observational study limitations.
This retrospective-prospective cohort study examined patients with Class I (clean) incisions within a healthcare system utilizing administrative Multi-departmental team (MDT) interventions. The study spanned three phases: baseline in 2017 (21,259 patients), Phase II from January 2020 to December 2022 (83,804 patients), and Phase III from January 2023 to December 2024 (76,259 patients). The comparator was baseline monitoring results from 2017.
The primary outcome measured the prophylactic antibiotic use rate for Class I incisions. Results demonstrated a decrease from 33.72% at baseline to 29.01% in Phase II and 25.91% in Phase III. Absolute numbers were 7,168 out of 21,259 at baseline, 24,314 out of 83,804 in Phase II, and 19,757 out of 76,259 in Phase III. The p-value for this decrease was 0.000.
Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. Key limitations include the observational nature of the study and the lack of reported causality or funding information. The practice relevance involves evaluating the use of perioperative prophylactic antibiotics in Class I incisions after implementing administrative MDT interventions.
View Original Abstract ↓
BackgroundPerioperative antibiotic prophylaxis plays a key role in preventing surgical site infections (SSIs). However, inappropriate use may increase the risk of antimicrobial resistance and SSIs. This study aims to evaluate the use of perioperative prophylactic antibiotics in Class I incisions after implementing administrative multidisciplinary team (MDT) interventions and assess the effectiveness of these interventions in improving management practices.MethodsRetrospective collection of perioperative data from 2017 served as baseline data. The administrative intervention was divided into three phases: Phase I: The administrative Multi-departmental team (MDT) was composed of Medical Affairs Department, Hospital Infection Management Department, and Pharmacy Department (January 2018–December 2019). During this phase, the three departments will collaboratively conduct surveillance, evaluation, and public reporting on perioperative antimicrobial prophylaxis for Class I (clean) incisions and organize targeted training initiatives based on the findings. Phase II: The “administrative MDT” model will now be comprehensively expanded and integrated into key areas of our healthcare system, encompassing the Nursing department, Operating room, Anesthesiology department, and various clinical units. This strategic development will span a multi-department joint intervention phase, commencing from January 2020 and concluding in December 2022; Simultaneously, targeted improvement measures were implemented to address issues identified in Phase I. Phase III: Continuous follow-up (January 2023–December 2024), To evaluate the improvement effectiveness of each intervention phase compared to the baseline monitoring results.ResultsAfter administrative interventions, all monitoring indicators for prophylactic antibiotic use in Class I incisions showed significant improvement: The prophylactic antibiotic use rate for Class I incisions decreased from 33.72% (7,168/21259) at baseline to 29.01% (24,314/83804) in Phase II and further to 25.91% (19,757/76259) in Phase III, which were statistically significant different (p = 0.000
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