Appropriateness of surgical antimicrobial prophylaxis in Japanese university hospitals

Research Group of Japan Infection Prevention and Control Conference for National and Public University Hospitals

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Background: Surgical antimicrobial prophylaxis (SAP) is one of the major purposes of antimicrobial use. Aim: To determine the adherence to the Japanese SAP guidelines in Japanese university hospitals. Methods: This was a retrospective cohort study including 15 general hospitals and one dental university hospital. Up to three cases of 18 designated surgeries were evaluated regarding adherence to Japanese SAP guidelines: selection of antibiotics, timing of administration, re-dosing intervals, and duration of SAP. When all items were appropriate, surgery was defined as ‘appropriate’. Findings: In total, 688 cases (22–45 cases per surgery) were included. The overall appropriateness was 46.8% (322/688), and the appropriateness of each surgery ranged from 8.0% (2/25, cardiac implantable electronic device implantation) to 92.1% (35/38, distal gastrectomy). The appropriateness of each item was as follows: pre/intraoperative selections, 78.5% (540/688); timing of administrations, 96.0% (630/656); re-dosing intervals, 91.6% (601/656); postoperative selection, 78.9% (543/688); and duration of SAP, 61.4% (423/688). The overall appropriateness of hospitals ranged from 17.6% (9/51) to 73.3% (33/45). The common reasons for inappropriateness were the longer duration (38.5%, 265/688) and choice of antibiotics with a non-optimal antimicrobial spectrum before/during, and after surgery (19.0%, 131/688 and 16.9%, 116/688, respectively), compared to the guideline. Conclusions: Adherence to the guidelines differed greatly between the surgeries and hospitals. Large-scale multi-centre surveillance of SAP in Japanese hospitals is necessary to identify inappropriate surgeries, factors related to the appropriateness, and incidences of surgical site infections.

Original languageEnglish
Pages (from-to)189-197
Number of pages9
JournalJournal of Hospital Infection
Publication statusPublished - Nov 2022

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases


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