RESUMO
Objetivo. Evaluar el grado de adecuación al protocolo de profilaxis antibiótica en pacientes intervenidos de artroplastia de rodilla y su influencia en la infección quirúrgica. Material y método. Se realizó un estudio de cohortes prospectivo. El grado de adecuación se estudió mediante la comparación de las características de la profilaxis recibida por los pacientes y la estipulada en el protocolo vigente de nuestro hospital. El efecto de la profilaxis en la incidencia de la infección quirúrgica se estimó con el riesgo relativo. Resultados. Se incluyeron 1.749 intervenciones. La incidencia de infección del sitio quirúrgico fue del 1,43% (n=25). La adecuación global al protocolo de profilaxis antibiótica fue del 77,6%. La causa más frecuente de inadecuación al protocolo fue la duración prescrita de los antibióticos de la profilaxis (46,5%). La adecuación de la profilaxis antibiótica no influyó en la infección del sitio quirúrgico (RR=1,15; IC 95%: 0,31-2,99; p>0,05). Discusión. Los programas de vigilancia y control de la infección permiten evaluar factores de riesgo de infección y evaluar medidas de mejora. La vigilancia de las tasas de infección quirúrgica nos permite tomar las medidas oportunas encaminadas a reducir progresivamente su incidencia. Conclusiones. La adecuación de la profilaxis antibiótica fue alta, pero se puede mejorar. No hubo relación entre la adecuación de la profilaxis y la incidencia de infección de la herida quirúrgica en artroplastia de rodilla (AU)
Objective. Antibiotic prophylaxis is the most suitable tool for preventing surgical wound infection. This study evaluated adequacy of antibiotic prophylaxis in surgery for knee arthroplasty and its effect on surgical site infection. Material and method. Prospective cohort study. We assessed the degree of adequacy of antibiotic prophylaxis, the causes of non-adequacy, and the effect of non-adequacy on surgical site infection. Incidence of surgical site infection was studied after a maximum incubation period of a year. To assess the effect of prophylaxis non-adequacy on surgical site infection we used the relative risk adjusted with the aid of a logistic regression model. Results. The study covered a total of 1749 patients. Antibiotic prophylaxis was indicated in all patients and administered in 99.8% of cases, with an overall protocol adequacy of 77.6%. The principal cause of non-compliance was the duration of prescription of the antibiotics (46.5%). Cumulative incidence of surgical site infection was 1.43%. No relationship was found between prophylaxis adequacy and surgical infection (RR=1.15; 95% CI: .31-2.99) (P>.05). Discussion. Surveillance and infection control programs enable risk factors of infection and improvement measures to be assessed. Monitoring infection rates enables us to reduce their incidence. Conclusions. Adequacy of antibiotic prophylaxis was high but could be improved. We did not find a relationship between prophylaxis adequacy and surgical site infection rate (AU)
Assuntos
Humanos , Masculino , Feminino , Idoso , Artroplastia do Joelho/instrumentação , Antibioticoprofilaxia/métodos , Infecção da Ferida Cirúrgica/prevenção & controle , Infecção da Ferida Cirúrgica/epidemiologia , Estudos Prospectivos , Estudos de Coortes , Modelos Logísticos , Staphylococcus aureus/isolamento & purificação , Staphylococcus epidermidis/isolamento & purificaçãoRESUMO
OBJECTIVE: Antibiotic prophylaxis is the most suitable tool for preventing surgical wound infection. This study evaluated adequacy of antibiotic prophylaxis in surgery for knee arthroplasty and its effect on surgical site infection. MATERIAL AND METHOD: Prospective cohort study. We assessed the degree of adequacy of antibiotic prophylaxis, the causes of non-adequacy, and the effect of non-adequacy on surgical site infection. Incidence of surgical site infection was studied after a maximum incubation period of a year. To assess the effect of prophylaxis non-adequacy on surgical site infection we used the relative risk adjusted with the aid of a logistic regression model. RESULTS: The study covered a total of 1749 patients. Antibiotic prophylaxis was indicated in all patients and administered in 99.8% of cases, with an overall protocol adequacy of 77.6%. The principal cause of non-compliance was the duration of prescription of the antibiotics (46.5%). Cumulative incidence of surgical site infection was 1.43%. No relationship was found between prophylaxis adequacy and surgical infection (RR=1.15; 95% CI: .31-2.99) (P>.05). DISCUSSION: Surveillance and infection control programs enable risk factors of infection and improvement measures to be assessed. Monitoring infection rates enables us to reduce their incidence. CONCLUSIONS: Adequacy of antibiotic prophylaxis was high but could be improved. We did not find a relationship between prophylaxis adequacy and surgical site infection rate.
