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How is surgical antibiotic prophylaxis prescribed for open reduction internal fixation procedures by Australian orthopaedic surgeons?

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dc.contributor.authorHassan, S.
dc.contributor.authorChan, V.
dc.contributor.authorStevens, J.E.
dc.contributor.authorStupans, I.
dc.contributor.authorGentle, J.
dc.date.issued2022
dc.description.abstractSurgical antibiotic prophylaxis (SAP) reduces the risk of surgical site infections following open reduction internal fixation (ORIF) procedures. Current guidelines recommend the use of single-dose prophylaxis for ORIF procedures. It is known that adherence to SAP guidelines is suboptimal across multiple surgical disciplines, including orthopaedic surgery. The aim of this study was to identify how Australian orthopaedic surgeons self-report prescribing of SAP for ORIF of closed fractures and whether practice adheres to recommendations in the Therapeutic Guidelines: Antibiotic version 16. An online survey was distributed to Australian orthopaedic surgeons between August 2020 and February 2021. The survey consisted of 10 questions relating to SAP prescribing practice for ORIF of closed fractures, guideline awareness, and factors that influence prescribing. Twenty-two surgeons participated in the survey. All 22 surgeons reported prescribing the guideline-adherent agent cefazolin for ORIF procedures, with 68.2% (n = 15) prescribing the non-adherent agent clindamycin for patients with a severe penicillin allergy. Almost two-thirds of the surgeons (63.6%) prescribe postoperative antibiotics, with two postoperative doses the most common regimen (57.1%). Although 63.6% of surgeons were aware of guideline content, adherence to guidelines varied. Surgeons noted that multiple factors influence their prescribing practice, including knowledge gained from personal readings (77.3%), habits developed during training (68.2%), and discussion with colleagues (63.6%). Factors that influence SAP decision making for ORIF procedures are multifactorial, with variable levels of guideline adherence. This small cohort of surgeons commonly reported prescribing postoperative antibiotics. Further research is required to understand what influences SAP decision-making.
dc.identifier.citationJournal of Pharmacy Practice and Research, 2022; 52(5):378-382
dc.identifier.doi10.1002/jppr.1823
dc.identifier.issn1445-937X
dc.identifier.issn2055-2335
dc.identifier.urihttps://hdl.handle.net/11541.2/30619
dc.language.isoen
dc.publisherWiley Blackwell Publishing Ltd
dc.rightsCopyright 2022 The Authors. This is an open access article under the terms of the License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. (http://creativecommons.org/licenses/by-nc-nd/4.0/) Access Condition Notes: Open access publishing facilitated by RMIT University, as part of the Wiley - RMIT University agreement via the Council of Australian University Librarians.
dc.source.urihttps://doi.org/10.1002/jppr.1823
dc.subjectclosed fractures
dc.subjectopen reduction internal fixation
dc.subjectprescribing practice
dc.subjectsurgical antibiotic prophylaxis
dc.subjectTherapeutic Guidelines
dc.titleHow is surgical antibiotic prophylaxis prescribed for open reduction internal fixation procedures by Australian orthopaedic surgeons?
dc.typeJournal article
pubs.publication-statusPublished
ror.fileinfo12250970110001831 13257199430001831 Pharmacy Practice and Res - 2022 - Hassan - How is surgical antibiotic prophylaxis prescribed for open reduction internal
ror.mmsid9916679020101831

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