Abstract
In April 2016, the Japanese Society of Chemotherapy and the Japan Society for Surgical Infection issued practical guidelines for the appropriate use of antibiotic prophylaxis for surgical site infections. At the obstetrics and gynecology department of our hospital, a multidisciplinary working group was established to promote the appropriate use of antibiotic prophylaxis for surgical site infections according to the guidelines (hereafter intervention). To visualize the progress of the intervention, the discontinuation rate (a proportion of cases in which antibiotics are appropriately discontinued), appropriate antibiotic selection rate of resuming antibiotic therapy, duration of postoperative hospital stay and costs of antibiotic were calculated from the Diagnosis Procedure Combination (DPC) data. To assess outcomes that could not be measured with the DPC data alone, medical records were also reviewed to determine the incidence rate of surgical site infection (SSI), incidence rate of fever of ≥ 38.5 ℃ on or after postoperative day 3, rate of resuming antibiotic therapy, and duration of postoperative hospital stay. Antibiotics were more appropriately used and selected after the intervention and costs of antibiotic were significantly decreased. The other 4 indices of outcome assessment remained unchanged before and after the intervention. The use of the DPC data permitted quantitative assessment of the progress and effects of the intervention.
