Investigating Antibiotic Usage in Patients Undergoing Gynecologic Surgery
ACOG ePoster. Brunozzi S. Apr 27, 2018; 211881; 2Q
Sabrina Brunozzi
Sabrina Brunozzi
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Abstract
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Introduction: Multiple studies have shown that indiscriminate antibiotic usage is linked to the development of antibiotic-resistant strains of bacteria. For gynecologic surgeries, the American Congress of Obstetricians and Gynecologists (ACOG) recommends the prophylactic usage of antibiotics for hysterectomy, urogynecologic procedures, hysterosalpingogram, and induced abortion. Conversely, ACOG does not recommend antibiotic prophylaxis in patients undergoing clean procedures with fewer risks for infection.

Methods: Based on these recommendations, a retrospective chart review was conducted of all women (N=1,338) who underwent gynecologic surgery between April 2015 and April 2016 at Moses Taylor Hospital in Scranton, PA and the use or non-use of antibiotics was analyzed in each case. Data that was collected included age, race, insurance provider, type of gynecologic procedure performed, antibiotic prescribed, and timing of administration.

Results: The results of this study showed that 161 of 167 patients (96.4%) received antibiotics appropriately when undergoing a procedure in which an antibiotic was indicated. Conversely, 210 of 1,171 patients (17.9%) received inappropriate antibiotic treatment when undergoing procedures where antibiotics were not indicated. Hysteroscopy was the most common procedure in which antibiotics were given inappropriately.

Conclusion/Implications: We recently implemented a quality improvement intervention targeted to improve compliance with ACOG recommendations. This includes dissemination of the recommendations in a simplified chart in the pre-operative areas and operating rooms, and re-training of surgeons, surgical staff, and anesthesia staff. The post-intervention phase is about to begin and the results will be presented. Improvement in outcomes and lessons learned from the intervention can potentially be used as a model for other institutions.
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