2026 年 52 巻 7 号 p. 415-426
Surgical site infections (SSIs) are associated with prolonged hospitalization, increased medical costs, and higher mortality rates. Optimizing perioperative prophylactic antibiotic use reduces SSI incidence. Nonetheless, evidence on the clinical impact of pharmacists’ involvement is still limited. This study aimed to assess the effects of perioperative pharmacist audit and feedback (PPAF) on SSI incidence and adherence to prophylactic antibiotic guidelines in patients undergoing colorectal surgery.
This retrospective cohort study involved patients who underwent colorectal surgery before (between January 1 and December 31, 2021) and after PPAF implementation (between May 1, 2024, and April 30, 2025). PPAF comprised a preoperative chart review, intervention based on body weight, renal function, allergy, recommendations for intraoperative redosing, and postoperative feedback. The primary outcome was SSI incidence. The secondary outcomes were adherence to prophylactic antibiotic guidelines, inappropriate antibiotic use, and associated costs.
We analyzed 410 patients (201 pre-PPAF and 209 post-PPAF). SSI incidence decreased from 18.4％ to 15.3％, with no statistical significance (odds ratio [OR]: 0.80, 95％ confidence interval [CI]: 0.46 – 1.39, P = 0.43). Guideline adherence improved across all categories, with significant improvements in preoperative timing and intraoperative redosing. Multivariate analysis identified (BMI) ≥ 21.8 and operative time ≥ 129 min as risk factors for SSI, whereas adherence to the prescribed dosage of postoperative infection prevention antibiotic was protective (OR: 0.20, 95％ CI: 0.05 – 0.87).
PPAF did not significantly reduce SSI incidence; nevertheless, it improved guideline adherence. Pharmacist-led interventions may contribute to enhancing the quality of perioperative care.
