AI Article Synopsis

  • Singapore has established institutional surgical antibiotic prophylaxis (SAP) guidelines in public hospitals, but adherence and tracking are inconsistent, with a 2020 survey revealing around 60% of prophylactic antibiotics were given for over 24 hours.
  • The guidelines were created by a diverse panel of experts using the ADAPTE methodology, focusing on evidence-based recommendations for the appropriate use of antibiotics during surgeries, with varying protocols for different patient groups.
  • The ultimate goal of these guidelines is to standardize practices across hospitals, improve the rational use of antibiotics in order to prevent surgical site infections, and minimize negative effects from unnecessary prolonged antibiotic use.

Article Abstract

Introduction: Institutional surgical antibiotic prophylaxis (SAP) guidelines are in place at all public hospitals in Singapore, but variations exist and adherence to guidelines is not tracked consistently. A national point prevalence survey carried out in 2020 showed that about 60% of surgical prophylactic antibiotics were administered for more than 24 hours. This guideline aims to align best practices nationally and provides a framework for audit and surveillance.

Method: This guideline was developed by the National Antimicrobial Stewardship Expert Panel's National Surgical Antibiotic Prophylaxis Guideline Development Workgroup Panel, which comprises infectious diseases physicians, pharmacists, surgeons and anaesthesiologists. The Workgroup adopted the ADAPTE methodology framework with modifications for the development of the guideline. The recommended duration of antibiotic prophylaxis was graded according to the strength of consolidated evidence based on the scoring system of the Singapore Ministry of Health Clinical Practice Guidelines.

Results: This National SAP Guideline provides evidence-based recommendations for the rational use of antibiotic prophylaxis. These include recommended agents, dose, timing and duration for patients undergoing common surgeries based on surgical disciplines. The Workgroup also provides antibiotic recommendations for special patient population groups (such as patients with β-lactam allergy and patients colonised with methicillin-resistant ), as well as for monitoring and surveillance of SAP.

Conclusion: This evidence-based National SAP Guideline for hospitals in Singapore aims to align practices and optimise the use of antibiotics for surgical prophylaxis for the prevention of surgical site infections while reducing adverse events from prolonged durations of SAP.

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Source
http://dx.doi.org/10.47102/annals-acadmedsg.2022273DOI Listing

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