예방적 항생제 사용 양상과 수술부위감염률의 관련성 (Association between the Pattern of Prophylactic Antibiotic Use and Surgical Site Infection Rate for Major Surgeries in Korea)

서지정보

· 발행기관 : 대한예방의학회
· 수록지 정보 : 예방의학회지 / 42권 / 1호 / 12 ~ 20페이지
· 저자명 : 사공필용, 이진석, 고광필, 김철환, 김윤, 이은정, 김용익

초록

Objectives : The purpose of this study was to analyze the
association between the pattern of prophylactic antibiotic
use (PAU) and the surgical site infection (SSI) rate for
major surgeries in Korea.
Methods : We retrospectively reviewed the medical
records of patients who underwent cardiac, colon and
gastric surgery, hysterectomies and hip/knee replacements
at 20 hospitals, and inclusive of over 500 beds. We
randomly sampled 60 cases per surgery type for patients
discharged between September and November, 2006. A
total fo 2,924 cases were included in our analysis. Cox s
proportional hazard analysis was conducted to evaluate the
association between the pattern of PAU and SSI rate.
Results : The proportion of patients who received their
first prophylactic antibiotics (PA) 1 hour before incision was
65.5%, who received inappropriate PAs was 80.8%, and
the proportion of patients whose PA was discontinued
within 24 hours of surgery was 0.5%. The average duration
of PAU after surgery was 9 days. The relative risk (RR) of
SSI in patients who received their first PA more than 1 hour
before incision was significantly higher than for those who
received it within 1 hour prior to incision (RR=8.20, 95%
CI=4.81-13.99). Inappropriate PA selection increased SSI
rate, albeit with marginal significance (RR=1.97, 95%
CI=0.96-4.03). Also, prolonged PAU following surgery had
no effect on SSI rate.
Conclusions : These results suggest that the pattern of
PAU in the surgeries examined was not appropriate. Errors
in the timing of PAU and of PA selection increase SSI rate.
SSI rate remained unaltered following prolonged PAU after
surgery.

영어초록

Objectives : The purpose of this study was to analyze the
association between the pattern of prophylactic antibiotic
use (PAU) and the surgical site infection (SSI) rate for
major surgeries in Korea.
Methods : We retrospectively reviewed the medical
records of patients who underwent cardiac, colon and
gastric surgery, hysterectomies and hip/knee replacements
at 20 hospitals, and inclusive of over 500 beds. We
randomly sampled 60 cases per surgery type for patients
discharged between September and November, 2006. A
total fo 2,924 cases were included in our analysis. Cox s
proportional hazard analysis was conducted to evaluate the
association between the pattern of PAU and SSI rate.
Results : The proportion of patients who received their
first prophylactic antibiotics (PA) 1 hour before incision was
65.5%, who received inappropriate PAs was 80.8%, and
the proportion of patients whose PA was discontinued
within 24 hours of surgery was 0.5%. The average duration
of PAU after surgery was 9 days. The relative risk (RR) of
SSI in patients who received their first PA more than 1 hour
before incision was significantly higher than for those who
received it within 1 hour prior to incision (RR=8.20, 95%
CI=4.81-13.99). Inappropriate PA selection increased SSI
rate, albeit with marginal significance (RR=1.97, 95%
CI=0.96-4.03). Also, prolonged PAU following surgery had
no effect on SSI rate.
Conclusions : These results suggest that the pattern of
PAU in the surgeries examined was not appropriate. Errors
in the timing of PAU and of PA selection increase SSI rate.
SSI rate remained unaltered following prolonged PAU after
surgery.

참고자료

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