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Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy

자궁적출술 후 예방적 항생제 사용 여부별 수술 후 합병증, 재원기간 및 치료비 비교

  • Received : 2016.09.09
  • Accepted : 2016.12.26
  • Published : 2017.03.20

Abstract

Purpose: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. Methods: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for $x^2$ test, t-test and ANCOVA. Results:Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). Conclusion: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.

Keywords

References

  1. KimBN. Overviewof antibiotic use in Korea. Infection &Chemotherapy. 2012;44(4):250-262. https://doi.org/10.3947/ic.2012.44.4.250
  2. Korean Society for Nosocomial Infection Control. Infection control and prevention in healthcare facilities. Seoul: Hanmi Medical Publishing; 2011. p. 3-21, 161-163.
  3. Park ES, KimKS, LeeWJ, Jang SY,Choi JY, Kim JM. The economical impacts of surgical site infections. Korean Journal of Nosocomial Infection Control. 2005;10(2):57-64.
  4. Chang JH, KimKH, KwonSM, Yeom SA, Park CS. The effect of surgical site infection on the length of stay and health care costs. Health Policy andManagement. 2011;21(1):44-60.
  5. Jo JH, Lee SH, Ahn BK, Baek SU. Efficacy of 24 hour-administration of antibiotic prophylaxis after elective colorectal surgery. Journal of the Korean Surgical Society. 2008;74(2):129-133.
  6. WaseyN, Baughan J, deGara CJ. Prophylaxis in elective colorectal surgery: The cost of ignoring the evidence. Canadian Journal of Surgery. 2003;46(4):279-284.
  7. HsuC, Cheng SH. Practice guideline adherence and health care outcomes -Use of prophylactic antibiotics during surgery in Taiwan. Journal of Evaluation in Clinical Practice. 2009;15(6) 1091-1096. https://doi.org/10.1111/j.1365-2753.2009.01182.x
  8. Snyder RJ. The use of prophylactic antibiotics in surgery. Podiatry Management. 2007;26(8): 203-210.
  9. Sakong P, Lee JS, Lee EJ, KoKP, KimCH, Kim Y, et al.Association between the pattern of prophylactic antibiotic use and surgical site infection rate formajor surgeries inKorea. Journal of PreventiveMedicine and Public Health. 2009;42(1):12-20.
  10. Zmora O,Wexner SD, Hajjar L, Park T, Efron JE, Nogueras JJ, et al. Trends in preparation for colorectal surgery: Survey of themembersof the American Society of Colon and Rectal Surgeons. The American Surgeon. 2003;69(2):150-154.
  11. BratzlerDW,Dellinger EP,OlsenKM, Perl TM,Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. American Journal of Health- System Pharmacy. 2013;70(3):195-283. https://doi.org/10.2146/ajhp120568
  12. KimES, Park SW, Lee CS, Kwak YG,Moon C, KimBN. Impact of a national hospital evaluation program using clinical performance indicators on the use of surgical antibiotic prophylaxis in Korea. International Journal of Infectious Diseases. 2012;16(3):e187-e192. https://doi.org/10.1016/j.ijid.2011.11.010
  13. Hawrylyshyn PA, Bernstein P, Papsin FR. Short-term antibiotic prophylaxis in high-risk patients following cesarean section. American Journal of Obstetrics and Gynecology. 1983;145(3): 285-289. https://doi.org/10.1016/0002-9378(83)90712-3
  14. Harger JH, EnglishDH. Selection of patients for antibiotics prophylaxis in cesarean section. American Journal of Obstetrics and Gynecology. 1981;141(7):752-758. https://doi.org/10.1016/0002-9378(81)90699-2
  15. Park JW, Oh JH, Choi HS, Yoo SB, Choe YJ, Park S, et al. A prospective, multicenter, randomized trial for duration of the prophylactic antibiotics after elective colorectal surgery: 3 days versus 5 days. Journal of the Korean Society of Coloproctology. 2010;26(2):123-128. https://doi.org/10.3393/jksc.2010.26.2.123
  16. Yang JY,KimMS, KimYJ, LeeEB. Theprophylacticusesof antibiotics for the prevention of surgical site infection and the effects: The 3-year experience in a tertiary hospital. Quality Improvement in Health Care. 2012;18(1);71-78.
  17. Dobzyniak MA, Fischgrund JS, Hankins S, Herkowitz HN. Single versus multiple dose antibiotic prophylaxis in lumbar disc surgery. Spine. 2003;28(21):E453-E455. https://doi.org/10.1097/01.BRS.0000090839.61893.BE
  18. Lee HP, Jeon HW, Lee DW, Park NH, Park CS, Song YS, et al. Comparative study of single-dose cefonicid vs.multi-dose cefoxitin as prophylaxis in patients undergoing obstetric and gynecologic surgery. Obstetrics & Gynecology Science. 1995;38 (11):2138-2143.
  19. Min KS, Kim HS, Lee MA, Kim YI, Seo YS, Lee KH, et al. Prophylactic antibiotics in elective cesarean section. Korean Journal of Obstetrics & Gynecology. 2002;45(9):1511-1515.
  20. KimKH, Park CS, Chang JH, KimNS, Lee JS, Choi BR, et al. Association between prophylactic antibiotic use and surgical site infection based on quality assessment data in Korea. Journal of PreventiveMedicine and Public Health. 2010;43(3):235-244.
  21. Ko JK, Cho YK, YangHJ, ParkCW, Park JS, Jun JK, et al. Aprospective multicenter randomized study on prophylactic antibiotics use in cesarean section performed at tertiary center. Korean Journal of Obstetrics and Gynecology. 2010;53(3):227-234. https://doi.org/10.5468/kjog.2010.53.3.227
  22. Sullivan SA, Smith T, Chang E,Huley T, Vandorsten JP, Soper D.Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing postcesarean infectious morbidity: A randomized, controlled trial. American Journal of Obstetrics and Gynecology. 2007;196(5):e1-e5. https://doi.org/10.1016/j.ajog.2007.03.070
  23. Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: An advisory statement fromtheNational Surgical Infection Prevention Project. American Journal of Surgery. 2005;189 (4):395-404. https://doi.org/10.1016/j.amjsurg.2005.01.015
  24. Health Insurance Review & Assessment Service. Diagnosisrelated group [internet]. Seoul:Author; 2016 [cited 2016August 31]. Available from: http://www.hira.or.kr/dummy.do?pgmid=HIRAA020006000000&cmsurl=/cms/policy/02/01/1341852_27024.html&WT.ac=포괄수가제#none
  25. Holman JF,McGowan JE, Thomson JD. Perioperative antibiotics in major elective gynecologic surgery. Southern Medical Journal. 1978;71(4):417-420. https://doi.org/10.1097/00007611-197804000-00022
  26. Song KA, Jang HS, Ko IS, Kong SJ, Park HJ, Lee GE, et al. Clinical examination and nursing. Seoul: Soomoonsa; 1998. p. 65-68.

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