OBJECTIVE: To examine guideline-based use of prophylactic antibiotics in patients who underwent gynecologic surgery. METHODS: We identified women who underwent gynecologic surgery between 2003 and 2010. Procedures were stratified as antibiotic-appropriate (abdominal, vaginal, or laparoscopically assisted vaginal hysterectomy) or antibiotic-inappropriate (oophorectomy, cystectomy, tubal ligation, dilation and curettage, myomectomy, and tubal ligation). Antibiotic use was examined using hierarchical regression models. RESULTS: Among 545,332 women who underwent procedures for which antibiotics were recommended, 87.1% received appropriate antibiotic prophylaxis, 2.3% received nonguideline-recommended antibiotics, and 10.6% received no prophylaxis. Use of antibiotics increased from 88.0% in 2003 to 90.7% in 2010 (P<.001). Among 491,071, who underwent operations for which antibiotics were not recommended, antibiotics were administered to 197,226 (40.2%) women. Use of nonguideline-based antibiotics also increased over time from 33.4% in 2003 to 43.7% in 2010 (P<.001). Year of diagnosis, surgeon and hospital procedural volume, and area of residence were the strongest predictors of guideline-based and nonguideline-based antibiotic use. CONCLUSION: Although use of antibiotics is high for women who should receive antibiotics, antibiotics are increasingly being administered to women for whom the drugs are of unproven benefit. LEVEL OF EVIDENCE: : III.
OBJECTIVE: To examine guideline-based use of prophylactic antibiotics in patients who underwent gynecologic surgery. METHODS: We identified women who underwent gynecologic surgery between 2003 and 2010. Procedures were stratified as antibiotic-appropriate (abdominal, vaginal, or laparoscopically assisted vaginal hysterectomy) or antibiotic-inappropriate (oophorectomy, cystectomy, tubal ligation, dilation and curettage, myomectomy, and tubal ligation). Antibiotic use was examined using hierarchical regression models. RESULTS: Among 545,332 women who underwent procedures for which antibiotics were recommended, 87.1% received appropriate antibiotic prophylaxis, 2.3% received nonguideline-recommended antibiotics, and 10.6% received no prophylaxis. Use of antibiotics increased from 88.0% in 2003 to 90.7% in 2010 (P<.001). Among 491,071, who underwent operations for which antibiotics were not recommended, antibiotics were administered to 197,226 (40.2%) women. Use of nonguideline-based antibiotics also increased over time from 33.4% in 2003 to 43.7% in 2010 (P<.001). Year of diagnosis, surgeon and hospital procedural volume, and area of residence were the strongest predictors of guideline-based and nonguideline-based antibiotic use. CONCLUSION: Although use of antibiotics is high for women who should receive antibiotics, antibiotics are increasingly being administered to women for whom the drugs are of unproven benefit. LEVEL OF EVIDENCE: : III.
Authors: Michael B Rothberg; Penelope S Pekow; Maureen Lahti; Oren Brody; Daniel J Skiest; Peter K Lindenauer Journal: JAMA Date: 2010-05-26 Impact factor: 56.272
Authors: Lisa J Rogo-Gupta; Sharyn N Lewin; Jin Hee Kim; William M Burke; Xuming Sun; Thomas J Herzog; Jason D Wright Journal: Obstet Gynecol Date: 2010-12 Impact factor: 7.661
Authors: David Leaper; Shona Burman-Roy; Ana Palanca; Katherine Cullen; Danielle Worster; Eva Gautam-Aitken; Martin Whittle Journal: BMJ Date: 2008-10-28
Authors: Jonah J Stulberg; Conor P Delaney; Duncan V Neuhauser; David C Aron; Pingfu Fu; Siran M Koroukian Journal: JAMA Date: 2010-06-23 Impact factor: 56.272
Authors: Peter K Lindenauer; Penelope S Pekow; Maureen C Lahti; Yoojin Lee; Evan M Benjamin; Michael B Rothberg Journal: JAMA Date: 2010-06-16 Impact factor: 56.272
Authors: Jason D Wright; Sharyn N Lewin; Israel Deutsch; William M Burke; Xuming Sun; Thomas J Herzog Journal: Obstet Gynecol Date: 2011-05 Impact factor: 7.661
Authors: Darrell A Campbell; William G Henderson; Michael J Englesbe; Bruce L Hall; Michael O'Reilly; Dale Bratzler; E Patchen Dellinger; Leigh Neumayer; Barbara L Bass; Matthew M Hutter; James Schwartz; Clifford Ko; Kamal Itani; Steven M Steinberg; Allan Siperstein; Robert G Sawyer; Douglas J Turner; Shukri F Khuri Journal: J Am Coll Surg Date: 2008-10-10 Impact factor: 6.113
Authors: Berthony Deslouches; Jonathan D Steckbeck; Jodi K Craigo; Yohei Doi; Jane L Burns; Ronald C Montelaro Journal: Antimicrob Agents Chemother Date: 2014-11-24 Impact factor: 5.191
Authors: Jason D Wright; Ling Chen; Lisa Gabor; William M Burke; Ana I Tergas; June Y Hou; Cande V Ananth; Alfred I Neugut; Dawn L Hershman Journal: Obstet Gynecol Date: 2017-07 Impact factor: 7.661
Authors: Margot E Cohen; Hojjat Salmasian; Jianhua Li; Jianfang Liu; Philip Zachariah; Jason D Wright; Daniel E Freedberg Journal: J Am Coll Surg Date: 2017-10-10 Impact factor: 6.113
Authors: Shitanshu Uppal; John Harris; Ahmed Al-Niaimi; Carolyn W Swenson; Mark D Pearlman; R Kevin Reynolds; Neil Kamdar; Ali Bazzi; Darrell A Campbell; Daniel M Morgan Journal: Obstet Gynecol Date: 2016-02 Impact factor: 7.661
Authors: Bradley D Menz; Esmita Charani; David L Gordon; Andrew J M Leather; S Ramani Moonesinghe; Cameron J Phillips Journal: Infect Drug Resist Date: 2021-12-07 Impact factor: 4.003