IRVING, Texas, June 16 /PRNewswire/ -- Surgical site infections, the second-most common cause of hospital-acquired infections, can be prevented if hospitals administer the right antibiotics, at the right time and in the right dosage. Representatives from leading national medical organizations, physicians and hospitals in the United States formed a workgroup to address this issue and have now developed consensus guidelines for preventive use of antibiotics to help reduce surgical infections. The guidelines were published in the June 15 issue of the journal, Clinical Infectious Diseases.
“If we consistently use the appropriate antibiotics an hour before surgery and halt antibiotic administration when it is no long necessary, we can dramatically improve morbidity and mortality associated with surgical infections,” said John Hitt, M.D., vice president of clinical improvement for VHA Inc., and one of the members of the workgroup that developed the consensus guidelines. “Furthermore, this will result in significant financial savings to hospitals.”
The Centers for Disease Control and Prevention estimates that 500,000 surgical site infections occur annually in the United States. Each infection is estimated to increase a hospital stay by an average of seven days and add more than $3,000 in costs. Patients who develop surgical site infections are up to 60 percent more likely to spend time in the intensive care unit, where care is more costly for the patient and the hospital. They also are five times more likely to be readmitted to the hospital. The causes of surgical site infection are inconsistent use of antibiotics, using the wrong antibiotics, inconsistent timing of antibiotic administration, or complete failure to use antibiotics prior to surgery.
The workgroup examined the best practices for antibiotic administration for five common surgical procedures: cardiothoracic surgery, vascular surgery, colon surgery, hip or knee replacement, and vaginal or abdominal hysterectomy. National performance data reveals that 25 percent of patients undergoing colon surgery do not receive the correct antibiotic to prevent infection; between 3 percent and 10 percent of other patients do not receive the correct antibiotic for surgery.
The most important recommendation by the panel was that antibiotics should be given one hour before surgery (on average, only 55 percent of surgical patients receive antibiotics within an hour of surgery) and should not be used for more than 24 hours after the end of the operation. Nationally, antibiotics are currently continued for an average of 40 hours following a surgical procedure. The panel validated that timely administration of antibiotics results in effective infection prevention and that a shorter duration of antibiotics is less likely to produce antibiotic-resistant bacteria.
“For some surgical procedures, hospitals are administering antibiotics as long as 96 hours following surgery, so a real savings opportunity exists for hospitals that adhere to the guidelines,” said Hitt. “Granted, the antibiotics used to prevent surgical infections are not the most expensive brands, but the savings are real. VHA is endorsing and encouraging a change of behavior among its member hospitals.”
Hitt said appropriate use of antibiotics will reduce: -- gastrointestinal side effects of some antibiotics -- related laboratory monitoring costs -- risk of allergic reactions for certain patients
The paper, “Antimicrobial Prophylaxis for Surgery: An Advisory Statement from the National Surgical Infection Prevention Project,” was the result of a yearlong effort by leading national medical organizations to identify best practices for preventing surgical site infections. The statement has been accepted by more than 20 medical societies and national health care organizations, including the American College of Surgeons, the American Academy of Orthopaedic Surgeons, and the Society of Thoracic Surgeons. The quality improvement project is co-sponsored by the Centers for Medicare & Medicaid Services and the Centers for Disease Control and Prevention, and is conducted through the CMS Health Care Quality Improvement Program. Its goal is to reduce the occurrence of post-operative infection by improving the selection and timing of preventative antibiotic administration.
Participating organizations were the American Academy of Orthopaedic Surgeons, American College of Obstetricians and Gynecologists, American College of Surgeons, American Geriatrics Society, American Society of Health- System Pharmacists, Infectious Diseases Society of America, The Medical Letter, Society of Thoracic Surgeons, Surgical Infection Society, Society for Healthcare Epidemiology of America, and VHA Inc.
About VHA
VHA Inc. is a national alliance of leading not-for-profit health care organizations working together to improve the health of the communities they serve. VHA leverages the collective strength of the membership to help members identify, integrate and implement best practices to improve clinical, operational and financial performance. As a cooperative, VHA distributes income annually to members based on their participation. Based in Irving, Texas, with 18 local offices across the U.S., VHA was named one of the “100 Best Companies to Work For” by Fortune in January 2004, for the fifth year in a row. For more information on VHA, go to: http://www.vha.com/ .
To reach John Hitt, M.D., of VHA, contact: Lynn Gentry 972/830-0798 lgentry@vha.com Other Contacts for the Media: Dale W. Bratzler, M.D. Peter M. Houck, M.D. 405/840-2891 206/615-2374 Oklahoma Foundation for Medical Quality CMS Leader for National Surgical Infection Prevention Project
Photo: Newscom: http://www.newscom.com/cgi-bin/prnh/20011017/VHALOGOAP Archive: http://photoarchive.ap.org/PRN Photo Desk, photodesk@prnewswire.comVHA Inc.
CONTACT: Lynn Gentry of VHA Inc., +1-972-830-0798, or lgentry@vha.com ;or Dale W. Bratzler, M.D. of Oklahoma Foundation for Medical Quality,+1-405-840-2891; or Peter M. Houck, M.D., CMS Leader, +1-206-615-2374, forNational Surgical Infection Prevention Project
