Guideline Adherence of Perioperative Antibiotics and Surgical Site Infections in Noncardiac Surgery

What is the association of adherence to Infectious Diseases Society of America (IDSA) perioperative antibiotic prophylaxis guidelines, covering antibiotic choice, dosing, timing, and intraoperative redosing, with surgical site infections (SSIs) after noncardiac surgery?In this cross-sectional study of 119 236 patients who underwent noncardiac surgery across 37 US institutions, nonadherence to at least 1 IDSA antibiotic metric occurred in 26.1% and was associated with higher SSI incidence (4.4% overall). Nonadherence to antibiotic choice and failure to redose intraoperatively were each independently associated with increased SSI risk.These findings suggest that improving adherence to IDSA antibiotic prophylaxis guidelines, particularly for antibiotic selection and redosing, may reduce SSIs and improve surgical outcomes.

Corresponding Author: Amit Bardia, MBBS, MPH, Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (abardia@mgb.org).

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