Management of the Antibiotic Prophylaxis Protocol in the Surgical Site Infection Rate

Surgical antibiotic prophylaxis aims to reduce the risk of surgical site infection (SSI). Studies indicate that SSIs account for 14–16% of HAIs, increasing morbidity and mortality and costs. Other studies show that the expected SSI incidence rate for clean surgeries ranges from 1 to 5% and that infections could be avoided with rational antibiotic use. The study aimed to assess whether systematic management of antibiotic prophylaxis, with a focus on timing of administration, redosing, and multiprofessional adherence, reduces SSI rates. This is a descriptive and retrospective study conducted in a medium-size elective surgical hospital in Aracaju/SE. Data collection was carried out in June 2025 through evaluation of electronic medical records of patients who underwent clean surgeries from June 2024 to May 2025. Information was tabulated in Microsoft Excel 2013 and the following indicators were analyzed: overall adherence to the protocol, antibiotic ≤1 h before incision, timely redosing, and SSI rate. The target for protocol adherence is 95%; SSI target ≤1.8%. Mean, standard deviation, and temporal correlation between process failures and SSI were calculated. A total of 1,417 medical records were evaluated and it was observed that overall adherence remained ≥95% (mean 98%), with administration before surgical incision between 97–100%. Appropriate redosing dropped to 83% in Aug/24 and 71% in Sep/24, coinciding with the months in which the SSI rate was 1.0% and 1.8%, respectively. After improvement actions such as surgeon feedback, meetings, dissemination of indicators, workflow strategies, and new processes, redosing reached 100% from Oct/24 onward. The mean SSI rate in the period was 0.54% ± 0.64%, reaching zero in nine of the twelve months. Rigorous management of the antibiotic prophylaxis protocol, combined with active monitoring and effective interventions for nonconformities, reduced and sustained the SSI rate below the institutional target. The findings reinforce that adherence to the institutional protocol is determinant to prevent SSIs and can be replicated in other care settings to improve surgical safety.