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Adherence to antimicrobial prophylaxis guidelines in cardiac implantable electronic device procedures in two Australian teaching hospitals.
- Source :
- Australian Health Review; 2021, Vol. 45 Issue 6, p761-770, 10p
- Publication Year :
- 2021
-
Abstract
- Objective. This study investigated antibiotic prophylaxis (AP) guideline adherence and the cardiac implantable electronic device (CIED) infection rate in two major Australian public teaching hospitals. Methods. In a retrospective observational study, the medical records of patients who underwent CIED procedures between January and December 2017 were reviewed (Hospital A, n = 400 procedures; Hospital B, n = 198 procedures). Adherence to AP guidelines was assessed regarding drug, dose, timing, route and frequency. Infection was identified using follow-up documentation. Results. AP was administered in 582 of 598 procedures (97.3%). Full guideline adherence was observed in 33.9% of procedures (203/598) and differed significantly between Hospitals A and B (47.3% vs 7.1%, respectively; P, 0.001). Common reasons for non-adherence were the timing of administration (42.3% vs 60.6% non-adherent in Hospitals A and B, respectively; P, 0.001) and repeat dosing (19.3% vs 78.8% non-adherent in Hospitals A and B, respectively; P, 0.001). Twenty infections were identified over 626.6 patient-years of follow-up (mean (-s.d.) follow-up 1.0 ± 0.3 years). The infection rate was 3.19 per 100 patient-years (P = 0.99 between hospitals). Two devices were removed due to infection; no patients died from CIED infection. Conclusions. Although the rate of serious CIED infection was low, there was evidence of highly variable and suboptimal antibiotic use, and potential overuse of AP. [ABSTRACT FROM AUTHOR]
- Subjects :
- INFECTION prevention
CARDIAC surgery
PATIENT aftercare
ACADEMIC medical centers
SCIENTIFIC observation
ACQUISITION of data methodology
CONFIDENCE intervals
CROSS-sectional method
IMPLANTABLE cardioverter-defibrillators
ELECTRONIC equipment
RETROSPECTIVE studies
ANTIBIOTIC prophylaxis
MEDICAL protocols
DOCUMENTATION
CARDIAC pacing
SURGICAL site infections
PUBLIC sector
MEDICAL records
DESCRIPTIVE statistics
DRUG prescribing
QUALITY assurance
CHI-squared test
PHYSICIAN practice patterns
STATISTICAL sampling
DATA analysis software
CARDIAC pacemakers
COMPLICATIONS of prosthesis
Subjects
Details
- Language :
- English
- ISSN :
- 01565788
- Volume :
- 45
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Australian Health Review
- Publication Type :
- Academic Journal
- Accession number :
- 154137361
- Full Text :
- https://doi.org/10.1071/AH21046