Anaesthetists’ knowledge of surgical antibiotic prophylaxis: a prospective descriptive study

Abstract

Background: Surgical site infection (SSI) is the second most common hospital-acquired infection and results in increased morbidity and mortality and a longer hospital stay. Surgical antibiotic prophylaxis (SAP) is one component of broader strategies to reduce rates of SSI. Adherence to SAP guidelines is largely sub-optimal globally, with knowledge of appropriate SAP being an important factor that affects this. The study’s objective was to describe awareness amongst anaesthetists at university-affiliated hospitals of available SAP guidelines and to describe their knowledge on the subject. Comparisons between senior and junior anaesthetists were to be made.

Methodology: A prospective descriptive study design using a self-administered questionnaire was employed. The study population was the anaesthetists in a university-affiliated Department of Anaesthesiology in Johannesburg, South Africa.

Results: The analysis included 135 completed questionnaires from the department’s anaesthetists. A total of 15.6% of participants followed a specific guideline in their practice, 28% for senior anaesthetists vs. 4.2% for junior anaesthetists. The overall mean score for knowledge was 56.2%, 59.3% for senior anaesthetists vs. 53.6% for junior anaesthetists, which was statistically significant (p-value < 0.001). Overall knowledge was found to be poor and, specifically, knowledge regarding indication for prophylaxis, antibiotic re-dosing interval and duration of prophylaxis was poor.

Conclusion: The anaesthetists had poor knowledge regarding SAP. While the difference in knowledge between senior and junior anaesthetists was statistically significant, is it likely that this difference would not be substantial enough to have a clinical impact. The authors recommend interventions to improve the knowledge of the anaesthetists regarding SAP as well as the development of local SAP guidelines.

Keywords: anaesthetist, antibiotics, knowledge, perioperative, surgical prophylaxis, surgical site infection