Current events in Obstetrics & Gynecology, updates on new web site features and links to other web sites of interest to ObGyns.

Saturday, November 23, 2013

Trailers (66): Antibiotic prophylaxis for gynecologic surgery

Wright et al. Use of guideline-based antibiotic prophylaxis in women undergoing gynecologic surgery

Why should you read about this topic?

The best way to prevent a surgical site infection for high risk procedures is with antibiotic prophylaxis.  Also, appropriate use of prophylactic antibiotics is a quality indicator for gynecologic surgery

What were the authors trying to do?

Ascertain the degree to which women received appropriate antibiotic prophylaxis prior to gynecologic surgery.

Who participated and in what setting?

Women (N=1,036,403) at least 18 years of age undergoing gynecologic surgery entered in the Perspective database between 2003-10

What was the study design?

Retrospective, population-based analysis of an administrative database

What were the main outcome measures?

Antibiotic utilization

What were the results?

Among women who underwent surgery for which prophylaxis was recommended, 87% received appropriate antibiotics, with a temporal trend for improvement.  However, for women undergoing surgery that required no prophylaxis, 40% received antibiotics, with a temporal trend for increasing use.

What is the most interesting image in the paper?

Figure 1

What were the study strengths and weaknesses?

Strengths: huge number of cases.   Weaknesses: errors inherent in an administrative database; inability to account for exceptional circumstances for antibiotic indications.

What does the study contribute for your practice?

More women are getting antibiotic prophylaxis for surgery than ever before, whether they need it or not.