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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 5 of 5 Research Studies DisplayedCabral SM, Harris AD, Cosgrove SE
Adherence to antimicrobial prophylaxis guidelines for elective surgeries across 825 US hospitals, 2019-2020.
This retrospective cohort study assessed adherence to surgical antimicrobial prophylaxis guidelines for elective surgeries across 825 US hospitals from 2019 to 2020. The authors looked at adults who underwent elective craniotomy, hip replacement, knee replacement, spinal procedure, or hernia repair in 2019-2020 at hospitals in the PINC AI (Premier) Healthcare Database. They evaluated adherence of prophylaxis regimes, with respect to antimicrobial agents endorsed in the American Society of Health-System Pharmacist guidelines, accounting for patient antibiotic allergy and methicillin-resistant Staphylococcus aureus colonization status. They found that across 825 hospitals and 521,091 inpatient elective surgeries, 59% were adherent to prophylaxis guidelines. The most common reason found for nonadherence was unnecessary vancomycin use. Patients receiving cefazolin plus vancomycin had 19% higher odds of acute kidney injury (AKI) compared with patients receiving cefazolin alone.
AHRQ-funded; HS028363.
Citation: Cabral SM, Harris AD, Cosgrove SE .
Adherence to antimicrobial prophylaxis guidelines for elective surgeries across 825 US hospitals, 2019-2020.
Clin Infect Dis 2023 Jun 16; 76(12):2106-15. doi: 10.1093/cid/ciad077..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Guidelines, Evidence-Based Practice, Surgery
Olsen MA, Greenberg JK, Peacock K
Lack of association of post-discharge prophylactic antibiotics with decreased risk of surgical site infection following spinal fusion.
This study’s objective was to determine the prevalence and factors associated with post-discharge prophylactic antibiotic use after spinal fusion and whether use was associated with decreased risk of surgical site infection (SSI). The study cohort included persons aged 10-64 years undergoing 156,446 spinal fusion procedures between January 2010 and July 2015. Excluded patients included complicated cases and those coded for infection from 30 days before to 2 days after surgical admission. Outpatient oral antibiotic prescriptions were identified within 2 days of surgical discharge. ICD-9-CM diagnosis codes were used to identify SSI within 90 days of surgery. Post-discharge prophylactic antibiotics were used in 9223 surgeries. SSIs occurred after 2557 procedures (1.6%). Factors significantly associated with post-discharge antibiotic use included history of lymphoma, diabetes, 3-7 versus 1-2 vertebral levels fused, and non-infectious postoperative complications. Analysis showed antibiotic use was not associated with decreased SSI risk after spinal fusion.
AHRQ-funded; HS019455; HS027075.
Citation: Olsen MA, Greenberg JK, Peacock K .
Lack of association of post-discharge prophylactic antibiotics with decreased risk of surgical site infection following spinal fusion.
J Antimicrob Chemother 2022 Mar 31;77(4):1178-84. doi: 10.1093/jac/dkab475..
Keywords: Antibiotics, Medication, Surgery, Antimicrobial Stewardship, Practice Patterns
Malone S, McKay VR, Krucylak C
A cluster randomized stepped-wedge trial to de-implement unnecessary post-operative antibiotics in children: the optimizing perioperative antibiotic in children (OPerAtiC) trial.
This paper describes an upcoming clinical trial to determine best strategies to de-implement inappropriate antibiotic use in pediatric post-operative surgical cases deemed low risk for infection. This study will provide important information on the impact of two potential strategies while assessing important clinical outcomes.
AHRQ-funded; HS026742.
Citation: Malone S, McKay VR, Krucylak C .
A cluster randomized stepped-wedge trial to de-implement unnecessary post-operative antibiotics in children: the optimizing perioperative antibiotic in children (OPerAtiC) trial.
Implement Sci 2021 Mar 19;16(1):29. doi: 10.1186/s13012-021-01096-1..
Keywords: Children/Adolescents, Antimicrobial Stewardship, Antibiotics, Medication, Surgery
Malone SM, Seigel NS, Newland JG
Understanding antibiotic prophylaxis prescribing in pediatric surgical specialties.
The objective of this study was to understand the factors that contribute to pediatric surgeons' decisions regarding the use of perioperative antibiotic prophylaxis. The investigators found that surgeons described a complex set of factors that impacted their antibiotic prescribing in pediatric surgical cases. They reported initial, but not ongoing, training and a use of individual weight of risk and benefit as a major dictator of prescribing practices.
AHRQ-funded; HS026742.
Citation: Malone SM, Seigel NS, Newland JG .
Understanding antibiotic prophylaxis prescribing in pediatric surgical specialties.
Infect Control Hosp Epidemiol 2020 Jun;41(6):666-71. doi: 10.1017/ice.2020.71..
Keywords: Children/Adolescents, Antibiotics, Surgery, Antimicrobial Stewardship, Medication, Practice Patterns
Johnson SP, Zhong L, Chung KC
Perioperative antibiotics for clean hand surgery: a national study.
This research is a national study on the use of prophylactic antibiotics in soft tissue hand surgery when antimicrobials are not indicated. Insurance claims from the Truven MarketScan Databases were used to identify patients who had 1 of 5 outpatient surgery procedures including: open or endoscopic carpal tunnel release; trigger finger release; de Ouervain release, and wrist ganglion excision between 2009 and 2015. An increase of 72.5% in prophylactic intravenous antibiotics was shown from 2009 to 2015. Patients with a younger age, male sex, lower income, or obesity had higher odds of receiving antibiotics. Total charge for these antibiotics equaled $1.6 million.
AHRQ-funded; HS023313.
Citation: Johnson SP, Zhong L, Chung KC .
Perioperative antibiotics for clean hand surgery: a national study.
J Hand Surg Am 2018 May;43(5):407-16.e1. doi: 10.1016/j.jhsa.2017.11.018..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Medication, Patient Safety, Surgery