Evaluation the Reasons for Non-compliance of Surgeons to Perioperative Antibiotic Prophylaxis

Introduction: Despite current medical and surgical advances, surgical site infections remain to be an important problem. Surgical site infections are an important cause of increased morbidity, mortality and healthcare cost in patients. Antimicrobial prophylaxis is a widely accepted procedure for the prevention of surgical site infections in the departments of surgery. The most common inappropriate use in perioperative antibiotic prophylaxis is the use of broad-spectrum antibiotics longer than normal. Materials and Methods: Physicians working in the departments of surgery of two different centers between December 1st, 2017 and March 1st, 2018 were included in the study. An informed voluntary consent form was received from the physician group involved, and then the questionnaire was filled out using face to face interview technique. Results: A total of 181 surgeons from 11 different surgical divisions were included into the study. Eighty-four point five percent of the surgeons participating in the study were males and the mean age was 41.5 +/- 6.6 (27-65) years. The most commonly used antibiotic in perioperative antibiotic prophylaxis was cefazolin with a rate of 77.9%. Eighty-seven point eight percent of the surgeons replied the question of "Have you ever used an inappropriate antimicrobial for surgical prophylaxis even once throughout your life?" as "yes", When the inappropriate antibiotic use of surgeons during prophylaxis was evaluated, it was determined that 88.1% of them kept the duration of postoperative antibiotic use longer, 61.6% of them failed to comply with a selection of antibiotic (broad-spectrum), 47.2% of them failed to comply with the initiation time of perioperative antibiotic prophylaxis. The most common cause of non-compliance with PAP was to avoid infection in a patient after a difficult surgery by surgeons (68.6%), considering a single-dose or short-term antibiotic therapy (1-2 days) would not be enough was the second leading reason (39.9%) and mistrusting operating room conditions was the most frequently determined third leading reason (37.7%). Conclusion: It Is important to emphasize that short-term prophylactic antibiotic administration is as effective as long-term antibiotic administration for the prevention of surgical site infections. Strategies and educations which will be developed on the basis of reasons will be helpful to reduce inappropriate prophylaxis rates of surgeons.