Kết quả triển khai quy trình kháng sinh dự phòng với sự tham gia của dược sĩ lâm sàng tại Khoa Chấn thương Chỉnh hình, Bệnh viện Đa khoa Đức Giang

Antimicrobial prophylaxis (AMP) is crucial for preventing surgical site infections (SSI), reducing healthcare costs, and combating antimicrobial resistance. While international and national guidelines exist, their effective implementation in clinical practice often faces challenges, including inappropriate antibiotic selection, timing, and duration, leading to prolonged use. This study addresses these practical gaps, particularly within the Department of Orthopedics & Trauma at Duc Giang General Hospital. It aims to assess the impact and effectiveness of a structured antimicrobial prophylaxis procedure, actively involving clinical pharmacists, to enhance adherence to guidelines and improve patient outcomes.

Healthcare professionals, hospital administrators, clinical pharmacists, orthopedic surgeons, and policymakers interested in antimicrobial stewardship and improving patient safety in surgical settings.

This study aimed to evaluate the effectiveness of implementing an antimicrobial prophylaxis (AMP) procedure with the active participation of clinical pharmacists at the Department of Orthopedics & Trauma, Duc Giang General Hospital. The research employed a prospective interventional design, conducted in two phases: a pilot phase (April-September 2024) involving 175 patients, followed by a routine phase (October 2024-March 2025). Data were meticulously collected from medical records of orthopedic surgical patients. Key findings from the pilot phase revealed an overall compliance rate of 76.6% with the AMP procedure, with 100% adherence to antibiotic selection and administration route. High compliance was also observed for dosage (95.4%) and duration (85.1%). Crucially, no surgical site infections (SSI) were reported, and significant antibiotic cost savings of 324,000-378,000 VND per patient were achieved. In the routine phase, 95.1% of eligible patients received prophylactic antibiotics, with monthly compliance ranging from 67% to 85%. The intervention demonstrated a substantial increase in compliance compared to pre-implementation rates, validating the significant role of clinical pharmacists in improving healthcare quality. The sustained absence of SSI during both phases underscores the procedure's efficacy and safety. The study concludes that this enhanced AMP procedure, supported by clinical pharmacists, not only improves adherence to guidelines and reduces costs but also maintains stable infection rates. It is recommended that this successful protocol be maintained and expanded to other clean/contaminated-clean surgeries within the hospital system to optimize antibiotic use and patient outcomes.