{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:45:41Z","timestamp":1790635541890,"version":"4.1.0"},"reference-count":31,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T00:00:00Z","timestamp":1586390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Surgical site infections (SSIs) are the most common healthcare-associated infections. The appropriate use of Surgical Antibiotic Prophylaxis (SAP) is a key component to reduce SSIs, while its inappropriate application is a major cause of some emerging infections and selects for antibiotic resistance. We describe an Antimicrobial Stewardship (AMS) intervention on SAP appropriateness. The prospective study was conducted in an Italian hospital, in 12 main surgical units, and was organized in three subsequent phases, as follows. Phase 0: Definition of hospital evidence-based guidelines and a new workflow to optimize the process of ordering, dispensing, administering and documenting the SAP. Phase 1: We analysed 2059 elective surgical cases from January to June 2018 for three SAP parameters of appropriateness: indication, choice and dose. Phase 2: In July 2018, an audit was performed to analyse the results; we reviewed 1781 elective surgical procedures from July to December 2018 looking for the same three SAP appropriateness parameters. The comparative analysis between phases 1 and 2 demonstrated that the correct indication, the correct dose and the overall compliance significantly improved (p-value 0.00128, p-value &lt; 2.2\u00b71016 and p-value &lt; 5.6\u00b71012 respectively). Our prospective study demonstrates a model of successful antimicrobial stewardship intervention that improves appropriateness on SAP.<\/jats:p>","DOI":"10.3390\/antibiotics9040168","type":"journal-article","created":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T03:40:19Z","timestamp":1586403619000},"page":"168","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Impact of Antimicrobial Stewardship Interventions on Appropriateness of Surgical Antibiotic Prophylaxis: How to Improve"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-7812","authenticated-orcid":false,"given":"Beatrice","family":"Tiri","sequence":"first","affiliation":[{"name":"Antimicrobial Stewardship Unit, Department of medicine, St. Maria Hospital, 05100 Terni; Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7124-1245","authenticated-orcid":false,"given":"Paolo","family":"Bruzzone","sequence":"additional","affiliation":[{"name":"Department of General and Specialist Surgery \u201cParide Stefanini\u201d, 00100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Priante","sequence":"additional","affiliation":[{"name":"Infectious Diseases Clinic, Department of medicine, St. Maria Hospital, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Sensi","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and Anesthesiology, St. Maria Hospital, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monya","family":"Costantini","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, St. Maria Hospital, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Vernelli","sequence":"additional","affiliation":[{"name":"Infectious Diseases Clinic, Department of medicine, St. Maria Hospital, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia Assunta","family":"Martella","sequence":"additional","affiliation":[{"name":"Infectious Diseases Clinic, Department of medicine, St. Maria Hospital, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marsilio","family":"Francucci","sequence":"additional","affiliation":[{"name":"Department of General and Oncologic Surgery, St. Maria Hospital, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Andreani","sequence":"additional","affiliation":[{"name":"Hematology and Microbiology Laboratory, St. Maria Hospital, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Mariottini","sequence":"additional","affiliation":[{"name":"Hematology and Microbiology Laboratory, St. Maria Hospital, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1337-8315","authenticated-orcid":false,"given":"Andrea","family":"Capotorti","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Informatics, University of Perugia, 06121 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5709-2530","authenticated-orcid":false,"given":"Vito","family":"D\u2019Andrea","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Sapienza University of Rome, 00100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Francisci","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Perugia, 06121 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2457-0636","authenticated-orcid":false,"given":"Roberto","family":"Cirocchi","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Perugia, 06121 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Cappanera","sequence":"additional","affiliation":[{"name":"Antimicrobial Stewardship Unit, Department of medicine, St. Maria Hospital, 05100 Terni; Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jamcollsurg.2016.10.029","article-title":"American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update","volume":"224","author":"Ban","year":"2017","journal-title":"J. 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