Background: Timely prophylactic antibiotic administration aids in preventing postoperative
superficial surgical site infections. However, during lengthy surgical procedures, redosing of
prophylactic antibiotics may be unintentionally omitted. We assessed the utility of a computerized
reminder as part of the anesthesia charting system to increase the rate of timely intraoperative
prophylactic antibiotic redosing.
Methods: A retrospective observational analysis was performed on consecutive patients undergoing
non-cardiac surgical procedures at a university-affiliated hospital prior to and after
the institution of a computerized reminder system. The reminder system presented the clinician
with a series of on-screen dialog boxes prior to the redose time for the specific prophylactic
antibiotic administered preoperatively. Antibiotic redosing was defined as appropriate
if it occurred within 30 min prior to or after the due time, calculated as twice the half-life of
the specific antibiotic. Patients were excluded if the case duration was less than twice the
half-life of the administered prophylactic antibiotic, or if no prophylactic antibiotic was given.
Results: A total of 287 cases were included in the study (148 pre-intervention, 139 post-intervention).
Patient age, case length, and American Society of Anesthesiologists (ASA) score
stratification did not differ between the groups. Use of the reminder system resulted in an
increase in the appropriate redosing of antibiotics from 20% prior to institution of the reminder
to 58% after institution (p < 0.001).
Conclusions: A computerized reminder system is an effective tool to assist in appropriate
intraoperative redosing of prophylactic antibiotics during lengthy surgical procedures.
