Antibiotic Guideline Gaps Raise SSI Risk

Nonadherence to IDSA/SIS/SHEA perioperative antibiotic prophylaxis guidelines associated with significantly higher surgical site infection rates, finds nationwide analysis.

By
Conexiant News Staff
March 3, 2026
3 min

Conexiant

Objective:

To analyze adherence to perioperative antibiotic prophylaxis guidelines (IDSA/SIS/SHEA) and its association with surgical site infection (SSI) risk.

Key Findings:

26.1% of cases were nonadherent to at least one antibiotic metric (p < 0.01).
SSIs occurred in 4.4% of cases.
Nonadherence to any guideline metric was associated with a 34% higher relative risk of SSI (RR, 1.34; 95% CI, 1.26-1.43).
Nonadherence to antibiotic choice had the highest association with SSI risk (RR, 1.43; 95% CI, 1.33-1.53).
Timing nonadherence was not significantly associated with SSI risk (RR, 1.13; 95% CI, 0.98-1.31).

Interpretation:

Improving antibiotic selection and ensuring appropriate redosing may reduce SSI risk more effectively than focusing solely on timing adherence; strategies for implementation should be considered.

Limitations:

Confounding by indication cannot be fully excluded, which may affect the observed associations.
Differences in case acuity and complexity between adherent and nonadherent cases may influence outcomes.