干旱区生态环境知识资源中心(Arid): Antibiotic use during repair of obstetrical anal sphincter injury: a quality improvement initiative

Arid

DOI	10.1002/ijgo.13623
	Antibiotic use during repair of obstetrical anal sphincter injury: a quality improvement initiative
	Cox, Caroline K.; Bugosh, Meghan D.; Fenner, Dee E.; Smith, Roger; Swenson, Carolyn W.
通讯作者	Cox, CK (corresponding author), Univ Penn, Dept Obstet & Gynecol, 800 Walnut St, Philadelphia, PA 19104 USA.
来源期刊	INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
ISSN	0020-7292
EISSN	1879-3479
出版年	2021-02
英文摘要	Objective To evaluate the effects of a quality improvement initiative regarding the administration of antibiotics at the time of obstetric anal sphincter injury (OASIS) repair. Methods At University of Michigan-a tertiary care center in Ann Arbor, MI, USA, we implemented a quality improvement intervention aimed at administering a single dose of broad-spectrum antibiotics at the time of OASIS repair. Best practice recommendations and reminders were presented to the department. Cefazolin plus metronidazole or clindamycin plus gentamycin were the recommended antibiotics. The effects of this intervention were assessed based on a chart review of deliveries between January 4, 2014 and February 13, 2019, which included patient data both pre-initiative and post-initiative to compare the prevalence of antibiotic use at the time of OASIS repair. Results Recommended antibiotic use increased from 0.3% (1/372) pre-initiative to 75.7% (106/140) post-initiative (P 0.001), and any antibiotic use increased from 6.5% (24/372) to 82.9% (116/140, P 0.001). The proportion of cases complicated by wound infection/breakdown decreased by 55% after the quality improvement intervention (3.2% pre-intervention vs 1.4% post-intervention, P = 0.22). Conclusion Following a departmental quality improvement intervention aimed at increasing antibiotic administration at the time of OASIS repair, antibiotic use increased 13-fold. Although underpowered to detect a significant difference in wound complications, our study showed a clinically meaningful decrease in wound infection/breakdown with antibiotic administration.
英文关键词	antibiotic prophylaxis OASIS obstetric anal sphincter injury postpartum infection quality improvement sphincter repair
类型	Article ; Early Access
语种	英语
收录类别	SCI-E
WOS记录号	WOS:000619445500001
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/352271
作者单位	[Cox, Caroline K.] Univ Penn, Dept Obstet & Gynecol, 800 Walnut St, Philadelphia, PA 19104 USA; [Bugosh, Meghan D.] IHA Obstet & Gynecol, Ann Arbor, MI USA; [Cox, Caroline K.; Bugosh, Meghan D.; Fenner, Dee E.; Smith, Roger; Swenson, Carolyn W.] Univ Michigan, Dept Obstet & Gynecol, Ann Arbor, MI 48109 USA
推荐引用方式 GB/T 7714	Cox, Caroline K.,Bugosh, Meghan D.,Fenner, Dee E.,et al. Antibiotic use during repair of obstetrical anal sphincter injury: a quality improvement initiative[J],2021.
APA	Cox, Caroline K.,Bugosh, Meghan D.,Fenner, Dee E.,Smith, Roger,&Swenson, Carolyn W..(2021).Antibiotic use during repair of obstetrical anal sphincter injury: a quality improvement initiative.INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS.
MLA	Cox, Caroline K.,et al."Antibiotic use during repair of obstetrical anal sphincter injury: a quality improvement initiative".INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS (2021).