Systematic review and evidence- based guidance ... - ECDC - Europa

Systematic review and evidence-based guidance on perioperative antibiotic prophylaxisTECHNICAL REPORT6 ConclusionsPerioperative antibiotic prophylaxis (PAP) is considered one of the most effective measures for preventing surgicalsite infections (SSI). Five key PAP modalities were identified by combining a systematic review by ranking theevidence by an expert group according to effectiveness, implementability and EU-wide applicability. Overallguidance and indicators for compliance monitoring were developed by consensus. The five modalities refer toeffective measures to improve the compliance of healthcare professionals with appropriate administration, timing,dosage and duration of PAP for preventing SSI.The indicators identified for monitoring the five key modalities include compliance with the indication, selection,timing, dosage and duration of PAP; the frequency of administration of PAP by an anaesthesiologist or anotherdesignated professional when indicated; the presence and frequency of meetings of the multidisciplinary team; andfurther measures to improve compliance.Identified barriers to the EU-wide implementation of the PAP modalities include lack of education, psychologicalbarriers, fear of litigation, lack of awareness regarding local antimicrobial resistance patterns, hierarchical problems,and lack of professional regulations. The key PAP modalities could help improve the compliance of healthcareprofessionals with PAP protocols and thereby reduce inappropriate antibiotic usage and decrease the prevalence ofMDROs in hospitals and countries in Europe.A common strategy within hospitals across Europe including the five key modalities and indicators will ensure andstrengthen the adequate administration of PAP. Barriers to implementation should be addressed, analysed andovercome by local, national or EU-wide strategies.36