Pre-operative antibiotic use reduces surgical site infection.

Objective: To assess the efficacy of World Health Organisation Surgical Safety Checklist as a simple, reliable and effective tool to ensure appropriate administration of intravenous antibiotics.

Methods: The prospective interventional study was conducted in three phases at Mayo Hospital, Lahore, from May 2011 to January 2012. The first phase comprised baseline data collection, followed by implementation of World Health Organisation Surgical Safety Checklist, and finally post-implementation data collection. The duration of each phase was 3 months. Primary end points were discharge from hospital, 30 days or death of the patient.

Results: Of the 613 patients in the study, 303(49.4%) were in the pre-implementation phase and 310(50.5%) in post-implementation phase. Adherence of optimal administration of antibiotic increased from 114(37.6%) to 282(91%) (p<0.001). The rate of post-operative infection fell from 99(32.7%) to 47(15.2%) (p<0.001). Mean hospital stay was reduced from 7.8±5.7 days to 6.5±5.6 days (p<0.001).

Conclusions: Appropriate and timely administration of antibiotic reduced surgical site infection by more than half. Hospital stay was shortened by 1.3 days on average which results in considerable reduction in morbidity, mortality and costs.