Current challenges in adherence to clinical guidelines for antibiotic prophylaxis in surgery

Khan, Sohil Ahmed and Rodrigues, Gabriel and Kumar, Pramod and Rao, Padma GM (2006) Current challenges in adherence to clinical guidelines for antibiotic prophylaxis in surgery. Journal of the College of Physicians and Surgeons, 16 (6). pp. 435-437.

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To study the impact of guidelines on surgical antibiotic prophylaxis in clinical practice, barriers involved in adherence to guidelines and how to overcome the same. Methods: Literature pertaining to prophylactic antibiotic usage was searched. Medscape, Medline, Cochrane, Surgical Infection Prevention (SIP) project databases were reviewed. Recent articles from relevant journals, texts, and standard guidelines were also studied. Results: Local guidelines seem more likely to be accepted and followed than those developed nationally. Major barriers involved in adherence to guidelines include lack of awareness about the guidelines, general perception of guideline as a bureaucratic rather than educational tool. Some practitioners perceive guidelines as "cookbook medicine" that does not permit them to make their own medical decisions. Other barriers are complex, multi-step systems that create confusion, decrease accountability. Methods for guideline adherence include surveillance and data analysis, new systems to facilitate documentation and improving workflow, education regarding current evidence-based guidelines and promoting the development of local guidelines or protocol, development and implementation of reminders to facilitate adherence to the local guidelines. Conclusion: A multidisciplinary steering team of surgeons, infectious disease specialists, pharmacists, anesthesiologists, microbiologists and nurses should develop local guidelines suitable to their institution and methods for adherence to prevent the surgical site infections. The gap between evidence-based guidelines and practice must be addressed in order to achieve optimal practice in this domain.

Item Type: Article
Uncontrolled Keywords: Surgical infection prevention; prophylactic antibiotics; guidelines.
Subjects: Pharmacy > MCOPS Manipal > Pharmacy Practice
Medicine > KMC Manipal > Plastic Surgery
Medicine > KMC Manipal > Surgery
Depositing User: KMC Library
Date Deposited: 03 Oct 2015 09:28
Last Modified: 03 Oct 2015 09:28

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