Observational study of 2-year data on the impact of an Antimicrobial Stewardship Committee’s focused department-level audit and feedback intervention on adherence to surgical prophylaxis guidelines at a secondary care hospital in the United Arab Emirates

Abstract

Introduction

Antimicrobial Stewardship Programs (ASPs) are critical in addressing Antimicrobial Resistance (AMR). Surgical Antibiotic Prophylaxis (SAP) guidelines provide essential guidance on antibiotic selection, administration, and duration for surgical procedures. This study evaluates the impact of department-level audit and feedback interventions within an ASP on compliance with SAP guidelines.

Objective

To assess the effect of a biannual audit and feedback initiative by the Antimicrobial Stewardship Committee over 2 years on compliance with SAP guidelines regarding antibiotic selection, timing, and duration at a secondary care hospital in the UAE.

Material & Methods

A quasi-experimental study was conducted at a secondary care hospital in Ras Al Khaimah, UAE, comparing data from the year before (2021) and 2 years after (2022–2023) the intervention. Statistical analysis was performed using the Open Epi system. All clean and clean-contaminated surgeries meeting SAP criteria were included; contaminated and dirty surgeries were excluded.

Results

The intervention significantly improved compliance with SAP guidelines. Appropriate antibiotic duration increased from 17% to 50%, and correct timing improved from 42% to 87%, both with a statistically significant p-value of 0.0001.

Conclusions

The audit and feedback intervention significantly enhanced compliance with SAP guidelines, particularly in timing and duration, contributing to reduced surgical site infections and costs. Implementing institute-wide SAP guidelines based on local antibiogram data is recommended to support clinicians and improve compliance.