ASSESSMENT OF ANTIBIOTIC USE IN OLDER ADULTS UNDERGOING ACUTE CARE SURGERY: A RETROSPECTIVE STUDY OF PROPHYLACTIC AND THERAPEUTIC PRACTICES
DOI:
https://doi.org/10.48047/3nw29e20Keywords:
Antibiotic use, Older adults, Acute care surgery, Perioperative antibiotic prophylaxis, Surgical patients, Antibiotic prescribing practicesAbstract
Background: This retrospective study aims to characterize antibiotic use among older adults admitted to acute care surgery services at a tertiary care teaching hospital, with a focus on evaluating adherence to published antibiotic prescribing guidelines. Methods: Data on diagnoses, chronic conditions, surgeries, and antibiotic administration were collected for 906 patients admitted to the hospital. Of these, 458 patients underwent surgery, primarily for small bowel obstruction and acute cholecystitis. The use of perioperative antibiotic prophylaxis was assessed for 502 non-elective abdominal surgeries, and antibiotic prescribing practices were compared to published guidelines. Results: 50.5% of patients undergoing non-elective abdominal surgery received perioperative antibiotic prophylaxis. Errors in antibiotic administration were identified, with 16.5% of patients receiving antibiotics at incorrect times and 13.4% receiving incorrect doses. 45.2% of patients received appropriate first-line antibiotics for their underlying condition. Inappropriate use of second or third-line antibiotics, as well as unnecessary use of first-line agents, was observed in a significant proportion of patients. Treatment duration varied significantly among patients with the same diagnosis. Conclusion:
The findings highlight a need for quality improvement initiatives to optimize antibiotic prescribing practices, minimize errors, and ensure optimal care for older surgical patients in complex hospital settings.
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