Practice variation in perioperative antibiotic use in Japan

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
Miho SekimotoTsuguya Fukui

Abstract

Under the fee-for-service system, the overuse and misuse of perioperative antibiotics have become serious concerns in Japan. The objective of the present study is to investigate practice variations of perioperative antimicrobial prophylaxis between and within hospitals, and to identify any opportunities for improvement. We polled 319 surgeons in six specialties employed by 11 teaching hospitals in Japan. We developed questionnaires with vignettes, asking physicians about their practice of antimicrobial prophylaxis in six surgical procedures (gastrectomy, hysterectomy, cataract surgery, clipping of cerebral aneurysm, hip fracture surgery, and coronary artery bypass graft) and utilization of institutional clinical pathways. Average durations of prophylaxis varied by procedure, from 1.6 days for cataract surgery to 5.8 days for clipping surgery. Variation was also observed between institutions for the same procedure, e.g. institutional averages for the duration of prophylaxis for gastrectomy ranged from 2.3 to 7 days. Large intra-institutional variation in prophylaxis duration and inconsistent use of clinical pathways were observed in the cases of gastrectomy, hip fracture surgery, and clipping surgery. At one hospital, 20% of phy...Continue Reading

Citations

Jan 15, 2011·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Shinobu Imai-Kamata, Kiyohide Fushimi
Jun 11, 2010·Journal of Preventive Medicine and Public Health = Yebang Ŭihakhoe Chi·Kyoung Hoon KimSeon A Yeom
Feb 1, 2011·The Journal of Hospital Infection·J LeeUNKNOWN Quality Indicator/Improvement Project (QIP) Expert Group for Clinical Evaluation
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Jul 29, 2017·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M E J L Hulscher, J M Prins

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