Compliance with antimicrobial stewardship guidelines in surgery: an observational, multidisciplinary, cohort study

Abstract Purpose Antimicrobial stewardship aims to improve clinical outcomes while reducing the unintended effects of antimicrobial use. The use of antibiotics in surgical wards, except for surgical antibiotic prophylaxis, has been poorly documented. Our goal was to assess the rate of compliance wit...

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Main Authors: Salomé Goncalves, Neyla Mohammedi, François Antonini, Alexandre Bleibtreu, Marwan Bouras, François Depret, Pierre Fillatre, Marc Garnier, Rémy Gauzit, Djamel Mokart, Véronique Mondain, Laurent Muller, Bruno Pastene, Mathilde Puges, Philippe Amabile, Cyrille Bastide, Stéphane V. Berdah, Xavier B. D’Journo, Xavier Flecher, Pierre-Hugues Roche, Gabriel Birgand, Carole Eldin, Marc Leone
Format: Article
Language:English
Published: BMC 2025-07-01
Series:World Journal of Emergency Surgery
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Online Access:https://doi.org/10.1186/s13017-025-00636-0
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author Salomé Goncalves
Neyla Mohammedi
François Antonini
Alexandre Bleibtreu
Marwan Bouras
François Depret
Pierre Fillatre
Marc Garnier
Rémy Gauzit
Djamel Mokart
Véronique Mondain
Laurent Muller
Bruno Pastene
Mathilde Puges
Philippe Amabile
Cyrille Bastide
Stéphane V. Berdah
Xavier B. D’Journo
Xavier Flecher
Pierre-Hugues Roche
Gabriel Birgand
Carole Eldin
Marc Leone
author_facet Salomé Goncalves
Neyla Mohammedi
François Antonini
Alexandre Bleibtreu
Marwan Bouras
François Depret
Pierre Fillatre
Marc Garnier
Rémy Gauzit
Djamel Mokart
Véronique Mondain
Laurent Muller
Bruno Pastene
Mathilde Puges
Philippe Amabile
Cyrille Bastide
Stéphane V. Berdah
Xavier B. D’Journo
Xavier Flecher
Pierre-Hugues Roche
Gabriel Birgand
Carole Eldin
Marc Leone
author_sort Salomé Goncalves
collection DOAJ
description Abstract Purpose Antimicrobial stewardship aims to improve clinical outcomes while reducing the unintended effects of antimicrobial use. The use of antibiotics in surgical wards, except for surgical antibiotic prophylaxis, has been poorly documented. Our goal was to assess the rate of compliance with the guidelines of antibiotic prescriptions in surgical wards. Method In a single academic center, a retrospective analysis was conducted over a two-month period to assess the rate of compliance with four criteria reflecting good practice in terms of antimicrobial stewardship: (1) decision of treatment initiation in line with the guidelines, (2) adequate spectrum of antibiotics in terms of patient characteristics; (3) duration of antibiotic treatment in compliance with the guidelines, and (4) whether re-adaptation of treatment was required. Positive responses to these four criteria indicated a 100% compliance rate. A pair of experts assessed the clinical vignettes to decide the compliance of each criterion. The secondary aims were to assess whether a 100% compliance rate was associated with positive outcomes. Results Among the 1,339 single stays in surgical wards, 232 patients (17%) received antibiotics during the study period. The rate of compliance with all four criteria was 33%. In addition, 149 (64%) patients complied with indication and spectrum, and 91 (39%) patients complied with indication, spectrum, and duration. Compliance with the antimicrobial treatment was associated with improved outcomes. Conclusion Of the patients hospitalized in the surgical wards, antimicrobial stewardship guidelines were complied with in 33% patients. Full compliance with the guidelines was associated with improved outcomes.
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spelling doaj-art-7cbacf8cf209464ab2b3422aaf8ec0322025-08-20T03:04:36ZengBMCWorld Journal of Emergency Surgery1749-79222025-07-012011910.1186/s13017-025-00636-0Compliance with antimicrobial stewardship guidelines in surgery: an observational, multidisciplinary, cohort studySalomé Goncalves0Neyla Mohammedi1François Antonini2Alexandre Bleibtreu3Marwan Bouras4François Depret5Pierre Fillatre6Marc Garnier7Rémy Gauzit8Djamel Mokart9Véronique Mondain10Laurent Muller11Bruno Pastene12Mathilde Puges13Philippe Amabile14Cyrille Bastide15Stéphane V. Berdah16Xavier B. D’Journo17Xavier Flecher18Pierre-Hugues Roche19Gabriel Birgand20Carole Eldin21Marc Leone22Department of Anesthesiology and Intensive Care Unit, Nord Hospital, Assistance Publique Hôpitaux Universitaires de MarseilleDepartment of Anesthesiology and Intensive Care Unit, Nord Hospital, Assistance Publique Hôpitaux Universitaires de MarseilleDepartment of Anesthesiology and Intensive Care Unit, Nord Hospital, Assistance Publique Hôpitaux Universitaires de MarseilleInfectious Disease Unit, La Pitié-Salpétrière University Hospital, AP-HP University of ParisCHU Nantes, Department of Anesthesiology and Intensive Care Unit, Nantes UniversityDepartment of Anesthesiology and Critical Care and Burn Unit, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St Louis-LariboisièreIntensive Care Unit, Centre Hospitalier Yves Le FollDépartement d’Anesthésie-Réanimation et Médecine Périopératoire, CHU de Clermont-FerrandInfectiologie Transversale, Réanimation Ollier, CHU CochinDepartment of Anesthesiology and Critical Care, Paoli-Calmettes InstituteService des Maladies Infectieuses et Tropicales, Centre Hospitalo-Universitaire de NiceDivision of Anesthesia, Critical Care, Pain and Emergency Medicine, UR-UM103 IMAGINE, University of Montpellier, Nimes University HospitalDepartment of Anesthesiology and Intensive Care Unit, Nord Hospital, Assistance Publique Hôpitaux Universitaires de MarseilleInfectious and Tropical Diseases Department, Centre Hospitalier Universitaire de BordeauxDepartment of Vascular Surgery, Nord Hospital, Assistance Publique Hôpitaux Universitaires de Marseille, Aix Marseille UniversityDepartment of Urology, Nord Hospital, Assistance Publique Hôpitaux Universitaires de Marseille, Aix Marseille UniversityDepartment of General Surgery, Nord Hospital, Assistance Publique Hôpitaux, Universitaires de Marseille, Aix-Marseille UniversityDepartment of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, Assistance Publique-Hôpitaux de Marseille and Aix-Marseille University, Hôpital NordAix-Marseille University, Assistance publique des hôpitaux de Marseille, Institut du mouvement et de l’appareil locomoteurDepartment of Neurology, Nord Hospital, Assistance Publique Hôpitaux Universitaires de Marseille, Aix Marseille UniversityCPias, Centre Hospitalo-Universitaire de NantesComité de Lutte contre les Infections Nosocomiales (CLIN), Hôpital NordDepartment of Anesthesiology and Intensive Care Unit, Nord Hospital, Assistance Publique Hôpitaux Universitaires de MarseilleAbstract Purpose Antimicrobial stewardship aims to improve clinical outcomes while reducing the unintended effects of antimicrobial use. The use of antibiotics in surgical wards, except for surgical antibiotic prophylaxis, has been poorly documented. Our goal was to assess the rate of compliance with the guidelines of antibiotic prescriptions in surgical wards. Method In a single academic center, a retrospective analysis was conducted over a two-month period to assess the rate of compliance with four criteria reflecting good practice in terms of antimicrobial stewardship: (1) decision of treatment initiation in line with the guidelines, (2) adequate spectrum of antibiotics in terms of patient characteristics; (3) duration of antibiotic treatment in compliance with the guidelines, and (4) whether re-adaptation of treatment was required. Positive responses to these four criteria indicated a 100% compliance rate. A pair of experts assessed the clinical vignettes to decide the compliance of each criterion. The secondary aims were to assess whether a 100% compliance rate was associated with positive outcomes. Results Among the 1,339 single stays in surgical wards, 232 patients (17%) received antibiotics during the study period. The rate of compliance with all four criteria was 33%. In addition, 149 (64%) patients complied with indication and spectrum, and 91 (39%) patients complied with indication, spectrum, and duration. Compliance with the antimicrobial treatment was associated with improved outcomes. Conclusion Of the patients hospitalized in the surgical wards, antimicrobial stewardship guidelines were complied with in 33% patients. Full compliance with the guidelines was associated with improved outcomes.https://doi.org/10.1186/s13017-025-00636-0AntibioticsSurgeryComplianceGuidelines
spellingShingle Salomé Goncalves
Neyla Mohammedi
François Antonini
Alexandre Bleibtreu
Marwan Bouras
François Depret
Pierre Fillatre
Marc Garnier
Rémy Gauzit
Djamel Mokart
Véronique Mondain
Laurent Muller
Bruno Pastene
Mathilde Puges
Philippe Amabile
Cyrille Bastide
Stéphane V. Berdah
Xavier B. D’Journo
Xavier Flecher
Pierre-Hugues Roche
Gabriel Birgand
Carole Eldin
Marc Leone
Compliance with antimicrobial stewardship guidelines in surgery: an observational, multidisciplinary, cohort study
World Journal of Emergency Surgery
Antibiotics
Surgery
Compliance
Guidelines
title Compliance with antimicrobial stewardship guidelines in surgery: an observational, multidisciplinary, cohort study
title_full Compliance with antimicrobial stewardship guidelines in surgery: an observational, multidisciplinary, cohort study
title_fullStr Compliance with antimicrobial stewardship guidelines in surgery: an observational, multidisciplinary, cohort study
title_full_unstemmed Compliance with antimicrobial stewardship guidelines in surgery: an observational, multidisciplinary, cohort study
title_short Compliance with antimicrobial stewardship guidelines in surgery: an observational, multidisciplinary, cohort study
title_sort compliance with antimicrobial stewardship guidelines in surgery an observational multidisciplinary cohort study
topic Antibiotics
Surgery
Compliance
Guidelines
url https://doi.org/10.1186/s13017-025-00636-0
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