Phân tích kết quả triển khai chương trình kháng sinh dự phòng trong phẫu thuật chấn thương chỉnh hình tại Bệnh viện Đa khoa tỉnh Phú Thọ

Abstract

Objective: To evaluate the initial outcomes of an antimicrobial stewardship program for surgical antibiotic prophylaxis (SAP) in patients undergoing clean orthopedic surgery at Phu Tho Provincial General Hospital. Subject and method: A prospective before–after observational study was conducted in patients undergoing clean orthopedic procedures at the Department of Orthopedic Surgery and Sports Medicine, Phu Tho Provincial General Hospital. The pre-intervention period was from January 1 to March 31, 2025, and the post-intervention period was from October 3, 2025, to February 28, 2026. The SAP stewardship program included development of institutional SAP guidelines, standardization of clinical workflows, healthcare staff training, and pharmacist-led monitoring of SAP practices. Data were collected from medical records, antibiotic use monitoring, and patient interviews up to 30 days after surgery. Result: Following implementation of the program, all patients received a single antibiotic dose within 1 hour before surgical incision, and postoperative antibiotic use was completely discontinued. No surgical site infections (SSIs) were observed during hospitalization or within 30 days after surgery in either study period. The median length of hospital stay decreased from 8.0 to 3.5 days. Direct antibiotic costs per patient were reduced by 5.85-fold, while consumable medical supply costs associated with antibiotic administration decreased by 12-fold. Conclusion: Implementation of a pharmacist-supported SAP stewardship program standardized prophylactic antibiotic practices in clean orthopedic surgery, eliminated unnecessary postoperative antibiotic use, shortened hospital stay, and generated substantial cost savings while maintaining effective SSI prevention.