KNOWLEDGE AND ATTITUDES OF SURGEONS ON THE USE AND STEWARDSHIP OF PROPHYLACTIC ANTIBIOTICS

Yıl 2023, Cilt: 26 Sayı: 2, 379 - 392, 23.06.2023

Aysun Kandemir Türe , Bayram Şahin

Öz

This study aimed to examine the reasons for using and not using surgical antibiotic prophylaxis (SAP), the reasons for inappropriate use, and the opinions and recommendations of the surgeons working in two public hospitals on the use of antibiotics. For this purpose, a questionnaire consisting of open and closed-ended questions developed using the literature was used. Between February 5 and September 6, 2019, when the research was carried out, 54 surgeons from a total of 58 surgeons working in these hospitals were reached and the questionnaire was applied one-to-one. Surgeons mostly rely on the recommendations of books or scientific articles (25.4%). They stated that avoidance of increasing the postoperative infection rate the most in their decision to apply SAP (8.3±2) and the fact that the conditions that fully comply with the information sources (5.9±3.7) were effective in their decision not to apply SAP. Most surgeons stated that they see the inappropriate use of SAP as a major problem and that inappropriate use is mostly due to unnecessary prophylaxis. 75.9% of surgeons think that an antibiotic management program is necessary. In a possible program, it is recommended to use the toolkit and antibiogram package as a strategy to monitor the use and provide feedback and to determine patient risk stratification as a tool. It is thought that the research findings will help the development of antibiotic management and education programs to improve antibiotic use. Also, the results obtained will be beneficial for the antibiotic control team or antibiotic management program planned to be established in hospitals. There is a need for training programs specifically targeting surgeons.

Anahtar Kelimeler

Surgical antibiotic prophylaxis, antimicrobial stewardship, surgeons

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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CERRAHLARIN PROFİLAKTİK ANTİBİYOTİK YÖNETİMİ VE KULLANIMI İLE İLGİLİ BİLGİ VE TUTUMLARI

Öz

Bu araştırmada, iki kamu hastanesinde görev yapan cerrahların cerrahi antibiyotik profilaksi (CAP) kullanma ve kullanmama nedenleri, uygunsuz kullanım nedenleri, antibiyotik kullanımı konusundaki görüş ve önerilerinin incelenmesi amaçlanmıştır. Bu amaçla literatürden yararlanılarak geliştirilen açık ve kapalı uçlu sorulardan oluşan bir soru formu kullanılmıştır. Araştırmanın yürütüldüğü 5 Şubat–6 Eylül 2019 tarihleri arasında bu hastanelerde görev yapan toplam 58 cerrahtan 54’üne ulaşılmış ve soru formu birebir uygulanmıştır. Cerrahlar en fazla kitap ya da bilimsel makalelerin önerilerini (%25,4) kaynak almaktadırlar. CAP uygulama kararı almalarında en fazla postoperatif enfeksiyon oranını artırmaktan kaçınma (8,3±2) ve CAP uygulamama kararı almalarında ise bilgi kaynaklarına tam uyan koşulların var olması (5,9±3,7) nedenlerinin etkili olduğunu belirtmişlerdir. Çoğu cerrah, uygun olmayan CAP kullanımını önemli bir sorun olarak gördüklerini ve uygunsuz kullanımın çoğunlukla gereksiz p rofilaksiden kaynaklandığını belirtmiştir. Cerrahların %75,9’u bir antibiyotik yönetim programının gerekli olduğunu düşünmektedir. Olası bir programda, strateji olarak kullanımın izlenmesi ve geri bildirim sağlanması ve araç olarak hasta risk sınıflandırmasının belirlenmesi için araç kiti ve antibiyogram paketinin kullanılması önerilmektedir. Araştırma bulgularının antibiyotik kullanımını geliştirmeye yönelik antibiyotik yönetimi ve eğitim programlarının geliştirilmesine yardımcı olacağı düşünülmektedir. Elde edilen sonuçların, hastanelerde kurulması planlanan antibiyotik kontrol ekibi ya da antibiyotik yönetim programı açısından faydalı olacağı düşünülmektedir. Özellikle cerrahları hedef alan eğitim programlarına ihtiyaç vardır.

Anahtar Kelimeler

Cerrahi antibiyotik profilaksisi, antimikrobiyal yönetimi, cerrahlar

Proje Numarası

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Kaynakça

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