Study reveals high rates of nonadherence to antimicrobial prophylaxis guidelines, often due to unnecessary vancomycin use

Summary: The study evaluated adherence to surgical antimicrobial prophylaxis guidelines in 825 US hospitals for elective surgeries from 2019-2020. The study found that 41% of surgical prophylaxis regimens were nonadherent to the American Society of Health-System Pharmacists guidelines.

Unnecessary vancomycin use was the most common reason for nonadherence to surgical antimicrobial prophylaxis guidelines, accounting for 77% of nonadherent regimens and occurring in 31% of all surgeries. It’s noteworthy that when vancomycin was used, it was often unnecessarily combined with cefazolin, and patients who received this combination had a 19% higher risk of acute kidney injury compared to those who received cefazolin alone.

The authors suggest that quality-improvement efforts aimed at reducing unnecessary vancomycin use and potential guideline revisions may offer impactful strategies for improving the risk-benefit profile of antimicrobial prophylaxis.

Article: Adherence to Antimicrobial Prophylaxis Guidelines for Elective Surgeries Across 825 US Hospitals, 2019–2020 – Clinical Infectious Diseases