Variation in Use of Prophylactic Antibiotics in Gynecologic Procedures.


eMediNexus    09 December 2017

A new study published in the Southern Medical Journal examined variations in the use of prophylactic antibiotics in patients undergoing gynecologic surgery, and to determine whether an educational intervention to gynecologists was associated with a significant decrease in unindicated prophylactic antibiotics. This was a retrospective chart review for all women undergoing gynecologic surgery at a hospital in Texas. An educational intervention regarding prophylactic antibiotic usage was held for obstetricians and gynecologists in the middle of that year. Subjects were included if they had procedures with a Current Procedural Terminology code corresponding to a procedure that does not require prophylactic antibiotics. The findings showed that a significant decrease in unindicated prophylactic antibiotic use was demonstrated – from 45.7% pre-intervention to 24.9% post-intervention. Before the educational intervention, gynecology oncology, reproductive endocrinology, and infertility divisions had the highest rates of unindicated antibiotic use, vis 91.7% and 91.7%, respectively. Whereas, the generalist and urogynecology divisions had the lowest rates for specialists before the intervention, vis 20.6% and 30.8%, respectively. Post-intervention, all the divisions demonstrated an improvement in their rates of unindicated prophylactic antibiotic use. The urogynecology division demonstrated an improvement that was clinically significant although statistically significant. Moreover, the adverse event rates were not different between subjects who received preoperative prophylactic antibiotics and in those who did not. Thus, it was concluded that a simple educational intervention was associated with a considerable decrease in unindicated prophylactic antibiotics in gynecologic procedures.

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