Download Abstract ID: AC001

Title: Multi-Center Indicator Intervention Research on Surgical Prophylaxis in 2
Hospitals in China
Author Name: Wang Qing
Email: [email protected]
Presenter Name: Wang Qing
Authors: Qing W (1), Yuqin W (2), Carandang E (3), Ross-Degnan D (4), Jinbo T (5)
Institution: Center for Drug Reevaluation (1); 2.Xuanwu Hospital (2); 3.WHO/EDM (3);
4.Harvard Medical School (4); Liuhuaqiao Hospital (5)
Problem Statement: Although guidelines existed for surgical prophylaxis in the Beijing
study hospitals, nobody followed them. There was also a great deal of overuse and
misuse of antibiotics.
Objectives: To formulate agreed-on prophylaxis guidelines, to cut down inappropriate
use, and decrease costs.
Design: Non-randomized before and after controlled trial.
Setting: The surgery departments of one intervention and one control large general
public sector hospital in Beijing city.
Study Population: All patients who received thyroidectomy, mastectomy,
cholecystectomy, and hysteromyomectomy plus appendectomy from June 1 to July 10 in
2000 and 2001.
Intervention: Surgeons and pharmacists from the intervention hospital were involved in
formulating evidence-based prophylaxis guidelines. These were printed and introduced to
all surgeons in small group training sessions. All operations were monitored and any
variances from the guidelines were reported back to the director of the surgical
department.
Outcome Measures: The average drug cost per operation; the average antibiotic cost per
operation; and the percent compliance with the guidelines.
Results: In the intervention hospital, the average drug cost was decreased from 1601 to
1490 Yuan, the average antibiotic cost was decreased from 740 to 352 Yuan (P <0.01),
and compliance with guidelines increased from 31% to 98% (P <0.01).
Conclusions: By including surgeons in formulating evidence-based prophylaxis
guidelines, carrying out small group training and actively monitoring compliance, it is
possible to make significant improvements in practice. These methods should now be
applied more widely in China.
Study Funding: WHO/EDM and Center for Drug Reevaluation of State Food and Drug
Administration, China