The impact and usefulness of the support tool for dosing design in adherence to the 'The Japanese Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery' on the incidence of surgical site infections and the amount of antimicrobial use

Abstract

Japanese Clinical Practice Guidelines for antimicrobial prophylaxis in surgery (hereinafter “Guidelines”) published in 2016 recommends the selection of antimicrobials in each surgery, intraoperative redosing interval, dosage prophylactic antimicrobials depending on renal function. Redosing interval is extended in patients with low renal function, due to this, it’s expected reduction in usage of antimicrobials. Reduction in usage of antimicrobials is effective for current instability in distribution of antimicrobials. In Fukuyama City Hospital, we decided to administer prophylactic antimicrobials in accordance with Guidelines in gastric cancer, colorectal cancer, and rectal cancer surgery from January 2024. Administration of antimicrobials was designed by pharmacists using support tool. The incidence rate of surgical site infection wasn’t changed before/after the intervention (16.7%/9.2%, P=0.188). The number of antimicrobials used per hour of surgery before/after the intervention was significantly decreased (0.47 vials/0.42 vials, P＜0.01). We will strive to improve the guideline compliance rate through using the support tool for dosing design.