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김경훈; 장진희; 김남순; 이진서; 최보람; 이병란; 이규덕; 김선민; 염선아; 박춘선

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자료유형: 학술저널

저자정보: 김경훈 장진희 김남순 이진서 최보람 이병란 이규덕 김선민 염선아 박춘선

저널정보: 대한예방의학회 예방의학회지 예방의학회지 제43권 제3호

발행연도: 2010.1

수록면: 235 - 244 (10page)

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Objectives: To examine the prophylactic antibiotic use in reducing surgical site infection. Methods: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy,colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review &Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. Results: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies,3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. Conclusions: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.

#Surgical site infection #Antibiotic prophylaxis #Hierarchical logistic regression

참고문헌 (22)

참고문헌 신청

Bowater RJ / 2009 / Is antibiotic prophylaxis in surgery a generally effective intervention? Testing a generic hypothesis over a set of meta-analyses / Ann Surg 249 (4) : 551

Bratzler DW / 2004 / Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project / Clin Infect Dis 38 (12) : 1706 ~ 1

Bratzler DW / 2005 / Use of antimicrobial prophylaxis for major surgery: baseline results from the National Surgical Infection Prevention Project / Arch Surg 140 (2) : 174 ~

Bratzler DW / 2006 / The surgical infection prevention and surgical care improvement projects: promises and pitfalls / Am Surg 72 (11) : 1010 ~ 1016

Choi WS / 2006 / The utilization of surgical antibiotic prophylaxis in 6 tertiary care hospitals / Infect Chemother 38 : S29 ~ S36

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