{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:17:27Z","timestamp":1791339447606,"version":"4.3.1"},"reference-count":38,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,10,18]],"date-time":"2020-10-18T00:00:00Z","timestamp":1602979200000},"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>Little is known regarding the factors associated with surgical antibiotic prophylaxis (SAP) compliance in elective minor surgery. The purposes of this cross-sectional study were to identify the frequency of inappropriate SAP administration and to understand the characteristics associated with such inappropriateness in a sample of elective minor surgical procedures. The study was performed between May and July 2019 among a random sample of patients aged 18\u2009years and older in seven public hospitals randomly selected in the Campania and Calabria Regions of Italy. Globally, only 45% of SAP approaches were deemed completely in accordance with the evidence-based guidelines. Patients with an ordinary admission, those who underwent local anesthesia, those receiving plastic and reconstructive and ophthalmology surgery, and those who had not received a prosthetic implant were more likely to receive an appropriate SAP approach; those receiving obstetrics, gynecological, and urological surgical procedures were less likely than those who underwent abdominal, vascular, and breast surgery. The course of antibiotic prophylaxis was not consistent with the guidelines in 48.5% procedures with one or more reasons for inappropriateness. Appropriate time of the SAP administration was more frequently observed in patients who were older, those with a Charlson comorbidity index of 0, those who did not receive a prosthetic implant, and those receiving plastic and reconstructive surgery; it was less likely in patients receiving obstetrics, gynecological, and urological surgeries compared with those who underwent abdominal, vascular, and breast surgery. Aspects of SAP that need to be improved are molecule choice, time of administration, and specific surgical procedures. Hospital managers should involve surgeons and anesthesiologists in initiatives tailored to optimize SAP prescribing.<\/jats:p>","DOI":"10.3390\/antibiotics9100713","type":"journal-article","created":{"date-parts":[[2020,10,18]],"date-time":"2020-10-18T21:26:06Z","timestamp":1603056366000},"page":"713","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Preoperative Antibiotic Prophylaxis in Elective Minor Surgical Procedures among Adults in Southern Italy"],"prefix":"10.3390","volume":"9","author":[{"given":"Giorgia","family":"Della Polla","sequence":"first","affiliation":[{"name":"Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, Via Luciano Armanni, 5 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4674-0306","authenticated-orcid":false,"given":"Aida","family":"Bianco","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University \u201cMagna Graecia\u201d of Catanzaro, Via Tommaso Campanella, 115 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8126-8054","authenticated-orcid":false,"given":"Silvia","family":"Mazzea","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University \u201cMagna Graecia\u201d of Catanzaro, Via Tommaso Campanella, 115 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4694-2418","authenticated-orcid":false,"given":"Francesco","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, Via Luciano Armanni, 5 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1213-6602","authenticated-orcid":false,"given":"Italo Francesco","family":"Angelillo","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, Via Luciano Armanni, 5 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,18]]},"reference":[{"key":"ref_1","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2019, October 21). Healthcare-Associated Infections: Surgical Site Infections\u2014Annual Epidemiological Report for 2017. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/healthcare-associated-infections-surgical-site-infections-annual-1."},{"key":"ref_2","first-page":"925","article-title":"Antimicrobial prophylaxis in surgery, Committee on Antimicrobial Agents, Canadian Infectious Disease Society","volume":"151","author":"Waddell","year":"1994","journal-title":"CMAJ Can. Med. Assoc. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.jhin.2016.12.016","article-title":"World Health Organization: Global guidelines for the prevention of surgical site infection","volume":"95","author":"Leaper","year":"2017","journal-title":"J. Hosp. Infect."},{"key":"ref_4","unstructured":"(2019, October 07). Guidelines for Safe Surgery 2009: Safe Surgery Saves Lives. Available online: http:\/\/whqlibdoc.who.int\/publications\/2009\/9789241598552eng.pdf."},{"key":"ref_5","unstructured":"Anderson, D.J., and Sexton, D.J. (2019, October 07). Antimicrobial Prophylaxis for Prevention of Surgical Site Infection in Adults: UpToDate 2018. Available online: https:\/\/www.uptodate.com\/contents\/antimicrobial-prophylaxis-for-prevention-of-surgical-site-infection-in-adults."},{"key":"ref_6","first-page":"671","article-title":"A study on the usage pattern of antimicrobial agents for the prevention of surgical site infections (SSIs) in a tertiary care teaching hospital","volume":"7","author":"Mirshad","year":"2013","journal-title":"J. Clin. Diagn. Res. JCDR"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"38","DOI":"10.18773\/austprescr.2005.030","article-title":"Antibiotics for surgical prophylaxis","volume":"28","author":"Munckhof","year":"2005","journal-title":"Aust. Prescr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1001\/jamasurg.2017.0904","article-title":"Centers for Disease Control and Prevention, Guideline for the prevention of surgical site infection, 2017","volume":"152","author":"Umscheid","year":"2017","journal-title":"JAMA Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.amjsurg.2005.01.015","article-title":"Antimicrobial prophylaxis for surgery: An advisory statement from the national surgical infection prevention project","volume":"189","author":"Bratzler","year":"2005","journal-title":"Am. J. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1017\/ice.2017.79","article-title":"Appropriateness of surgical antibiotic prophylaxis in pediatric patients in Italy","volume":"38","author":"Giordano","year":"2017","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.ajic.2017.05.004","article-title":"Improving compliance with surgical antibiotic prophylaxis guidelines: A multicenter evaluation","volume":"45","author":"Schmitt","year":"2017","journal-title":"Am. J. Infect. Control"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.accpm.2015.04.004","article-title":"Surgical antibiotic prophylaxis compliance in a university hospital","volume":"34","author":"Muller","year":"2015","journal-title":"Anaesth. Crit. Care Pain Med."},{"key":"ref_13","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":"Novaes","year":"2015","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Napolitano, F., Izzo, M., Di Giuseppe, G., Angellillo, I.F., and The Collaborative Working Group (2013). Evaluation of the appropriate perioperative antibiotic prophylaxis in Italy. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0079532"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/s15010-002-2170-6","article-title":"The practice of perioperative antibiotic prophylaxis in eight German hospitals","volume":"30","author":"Dettenkofer","year":"2002","journal-title":"Infection"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/jpc.14484","article-title":"Surgical antibiotic prophylaxis in children: Adherence to guidelines: A cohort study","volume":"56","author":"Palasanthiran","year":"2020","journal-title":"J. Paediatr. Child Health"},{"key":"ref_17","first-page":"e4793","article-title":"Evaluation of antibiotic prophylaxis and discharge prescriptions in the general surgery department","volume":"11","author":"Karaali","year":"2019","journal-title":"Cureus"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5152\/eurasianjmed.2015.15222","article-title":"An evaluation of surgical prophylaxis procedures in Turkey: A multi-center point prevalence study","volume":"48","author":"Kaya","year":"2016","journal-title":"Eurasian J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.ijsu.2018.08.012","article-title":"Is antibiotic prophylaxis mandatory in laparoscopic incisional hernia repair? Data from the herniamed registry","volume":"58","author":"Kirchhoff","year":"2018","journal-title":"Int. J. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.4103\/ijo.IJO_961_17","article-title":"Antibiotic prophylaxis in cataract surgery\u2014An evidence-based approach","volume":"65","author":"Haripriya","year":"2017","journal-title":"Indian J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1007\/s10029-013-1061-3","article-title":"Use of antibiotic prophylaxis in elective inguinal hernia repair in adults in London and south-east England: A cross-sectional survey","volume":"17","author":"Aiken","year":"2013","journal-title":"Hernia"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1213\/ANE.0000000000000956","article-title":"The impact of anesthetic management on surgical site infections in patients undergoing total knee or total hip arthroplasty","volume":"121","author":"Kopp","year":"2015","journal-title":"Anesth. Analg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1093\/bja\/aer262","article-title":"General anaesthesia is associated with increased risk of surgical site infection after Caesarean delivery compared with neuraxial anaesthesia: A population-based study","volume":"107","author":"Tsai","year":"2011","journal-title":"Br. J. Anaesth."},{"key":"ref_24","unstructured":"Sistema Nazionale per le Linee Guida (SNLG) Website (2020, May 08). Antibioticoprofilassi Perioperatoria Nell\u2019adulto. Linea Guida., Available online: https:\/\/www.anmdo.org\/wp-content\/uploads\/2016\/10\/Linee-guida-Antibioticoprofilassi-perioperatoria-nelladulto.pdf."},{"key":"ref_25","unstructured":"European Commission (2019, December 19). EU Guidelines for the Prudent Use of Antimicrobials in Human Health, Available online: https:\/\/ec.europa.eu\/health\/amr\/sites\/amr\/files\/amr_guidelines_prudent_use_en.pdf."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Musmar, S.M.J., Ba`ba, H., and Owais, A. (2014). Adherence to guidelines of antibiotic prophylactic use in surgery: A prospective cohort study in North West Bank, Palestine. BMC Surg., 14.","DOI":"10.1186\/1471-2482-14-69"},{"key":"ref_27","unstructured":"Scottish Intercollegiate Guidelines Network (SIGN) (2019, December 19). Antibiotic Prophylaxis in Surgery, SIGN, Edimburgh. Available online: http:\/\/www.sign.ac.uk\/pdf\/sign104.pdf."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1097\/SLA.0000000000000934","article-title":"Increasing compliance with an antibiotic prophylaxis guideline to prevent pediatric surgical site infection: Before and after study","volume":"262","author":"So","year":"2015","journal-title":"Ann. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"62","DOI":"10.4103\/2279-042X.137075","article-title":"Adherence to American society of health-system pharmacists surgical antibiotic prophylaxis guidelines in a teaching hospital","volume":"3","author":"Rafati","year":"2014","journal-title":"J. Res. Pharm. Pract."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e1915003","DOI":"10.1001\/jamanetworkopen.2019.15003","article-title":"Appropriateness of surgical antimicrobial prophylaxis practices in Australia","volume":"2","author":"Ierano","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.ajic.2014.01.001","article-title":"Audits of the quality of perioperative antibiotic prophylaxis in Shandong Province, China, 2006 to 2011","volume":"42","author":"Ou","year":"2014","journal-title":"Am. J. Infect. Control"},{"key":"ref_32","unstructured":"Agreement between the Ministry of Health, the Regions and the Autonomous Provinces of Trento and Bolzano (2019, September 12). National Action Plan on Antimicrobial Resistance (PNCAR) 2017\u20132020, Available online: http:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_2660_allegato.pdf."},{"key":"ref_33","first-page":"w20135","article-title":"Appropriateness of antimicrobial prescribing in a Swiss tertiary care hospital: A repeated point prevalence survey","volume":"149","author":"Erba","year":"2019","journal-title":"Swiss Med. Wkly."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e135","DOI":"10.3346\/jkms.2019.34.e135","article-title":"Appropriate prophylactic antibiotic use in clean wound surgery under local anesthesia","volume":"34","author":"Cha","year":"2019","journal-title":"J. Korean Med. Sci."},{"key":"ref_35","first-page":"373","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Clin. Epidemiol."},{"key":"ref_36","unstructured":"American Society of Anesthesiologists (2020, October 02). ASA Physical Status Classification System. Available online: https:\/\/www.asahq.org\/standards-and-guidelines\/asa-physical-status-classification-system."},{"key":"ref_37","unstructured":"(2020, May 08). Italian Society of Ophthalmology SOI 2013. Available online: https:\/\/www.sedesoi.com\/linee_guida.php."},{"key":"ref_38","unstructured":"StataCorp (2017). Stata Statistical Software: Release 15, StataCorp LLC."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/9\/10\/713\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:23:27Z","timestamp":1760178207000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/9\/10\/713"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,18]]},"references-count":38,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["antibiotics9100713"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics9100713","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,18]]}}}