To analyze adherence to perioperative antibiotic prophylaxis guidelines (IDSA/SIS/SHEA) and its association with surgical site infection (SSI) risk.
Approach:
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.
Conclusion:
Addressing gaps in antibiotic guideline adherence is a modifiable factor that could significantly reduce postoperative infections.
National survey data found lower per-capita representation across 23 occupations in nonmetropolitan communities, with the largest workforce differences observed among psychologists, physicians, and surgeons.
