{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:52:48Z","timestamp":1782496368513,"version":"3.54.5"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>The inappropriate use of surgical antibiotic prophylaxis (SAP) remains a common issue in Vietnam, posing a significant risk of surgical site infections (SSIs) and other adverse outcomes. This study aimed to evaluate the impact of a pharmacist-led audit\u2013feedback (A&amp;F) intervention, as part of an antimicrobial stewardship (AMS) program, on improving compliance with SAP guidelines. A prospective pre\u2013post interventional study was conducted in the surgical departments of Saint Paul General Hospital. A multidisciplinary team, led primarily by clinical pharmacists, conducted audit\u2013feedback activities on SAP practices from December 2023 to April 2024. The primary outcome was the overall compliance rate with SAP guidelines. Secondary outcomes included compliance with specific components: antibiotic selection, timing of administration, dosing, and duration of use. A total of 162 patients in the pre-intervention group and 147 in the post-intervention group were included. After two audit\u2013feedback phases, overall compliance with SAP guidelines significantly increased from 60.49% to 76.87% (OR: 2.97, 95% CI: 1.71\u20135.28). Notably, the most significant improvements were observed in the appropriateness of antibiotic selection and duration of use, increasing from 74.69% to 88.44% (OR: 2.57, 95%CI: 1.40\u20134.89) and 72.84% to 88.44% (OR: 2.82, 95% CI: 1.55\u20135.36), respectively. Conclusion, the audit\u2013feedback intervention led by clinical pharmacists substantially improved compliance with SAP guidelines across several domains. This study provides pragmatic evidence from a tertiary hospital in Vietnam, demonstrating that audit\u2013feedback is not only feasible but also impactful in resource-limited settings. Importantly, this approach could inform scalable AMS and infection prevention policies in other low-and middle-income countries.<\/jats:p>","DOI":"10.1371\/journal.pone.0351068","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:27:23Z","timestamp":1782494843000},"page":"e0351068","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing surgical antimicrobial prophylaxis through clinical pharmacist-led audit and feedback: Evidence from a Vietnamese tertiary hospital"],"prefix":"10.1371","volume":"21","author":[{"given":"Dua Thi","family":"Nguyen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Son Ngoc","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thu Thi Huyen","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy Thi Thu","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long Duc","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trang Hoang Quynh","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao Trong","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shukry","family":"Zawahir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai Thanh","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy Thi Thu","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Van Thi Thuy","family":"Pham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh Duong Anh","family":"Vu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phuong Thi Xuan","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3817-1126","authenticated-orcid":true,"given":"Son Tu","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"issue":"2","key":"pone.0351068.ref001","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1089\/sur.2015.073","article-title":"Surgical Site Infection Rates in Seven Cities in Vietnam: Findings of the International Nosocomial Infection Control Consortium","volume":"17","author":"N Viet Hung","year":"2016","journal-title":"Surg Infect (Larchmt)"},{"key":"pone.0351068.ref002","unstructured":"Vietnam Ministry of Health. National guideline for prevention of surgical site infections. 2012."},{"issue":"2","key":"pone.0351068.ref003","article-title":"Antibiotic prophylaxis for hernia repair","volume":"2012","author":"FJ Sanchez-Manuel","year":"2012","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"1","key":"pone.0351068.ref004","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1089\/sur.2013.9999","article-title":"Clinical practice guidelines for antimicrobial prophylaxis in surgery","volume":"14","author":"DW Bratzler","year":"2013","journal-title":"Surg Infect (Larchmt)"},{"key":"pone.0351068.ref005","first-page":"27","article-title":"Appropriate perioperative antibiotic prophylaxis: challenges, strategies, and quality indicators","volume":"39","author":"A Agodi","year":"2015","journal-title":"Epidemiol Prev"},{"issue":"5","key":"pone.0351068.ref006","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.bjid.2015.06.004","article-title":"Adherence to guidelines for surgical antibiotic prophylaxis: a review","volume":"19","author":"M Gouv\u00eaa","year":"2015","journal-title":"Braz J Infect Dis"},{"issue":"533","key":"pone.0351068.ref007","article-title":"Characteristics of antibiotic use in patients undergoing clean surgery, clean-contaminated surgery at the department of cardiovascular and thoracic surgery, Viet Duc university hospital","volume":"1","author":"THT Vo","year":"2025","journal-title":"Viet Nam Medical J"},{"key":"pone.0351068.ref008","unstructured":"World Health Organization. Antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries. A WHO practical toolkit. 2019."},{"key":"pone.0351068.ref009","article-title":"Core elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention","author":"LA Pollack","year":"2014","journal-title":"Clin Infect Dis"},{"key":"pone.0351068.ref010","article-title":"UK recommendations for combating antimicrobial resistance: a review of \u201cantimicrobial stewardship: systems and processes for effective antimicrobial medicine use\u201d (NICE guideline NG15, 2015) and related guidance","author":"GL Morley","year":"2017","journal-title":"Arch Dis Child Educ Pract Ed"},{"issue":"6","key":"pone.0351068.ref011","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1093\/jac\/dkg264","article-title":"Adherence to local hospital guidelines for surgical antimicrobial prophylaxis: a multicentre audit in Dutch hospitals","volume":"51","author":"MEE van Kasteren","year":"2003","journal-title":"J Antimicrob Chemother"},{"issue":"4","key":"pone.0351068.ref012","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD003543.pub2","article-title":"Interventions to improve antibiotic prescribing practices for hospital inpatients","author":"P Davey","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0351068.ref013","unstructured":"Vietnam Ministry of Health. 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