Improving peri-procedural antibiotics adherence in oncology department

Many patients in oncology wards will need some type of interventional procedure undertaken mostly by Interventional Radiology and Gastroenterology departments. And many procedures require periprocedural antibiotics.We identified instances where the periprocedural antibiotics prescription was either missed or was not according to guidelines. Patients undergoing invasive procedures are particularly vulnerable to infections due to their compromised immune systems.1 Antibiotics play a pivotal role in preventing such infections. However, the inappropriate or missed administration of periprocedural antibiotics poses a significant risk, treatment complications, contributing to antibiotic resistance, and increased healthcare costs.2 Several contributing factors to inappropriate periprocedural antibiotic use in oncology have been identified. These factors encompass variability in clinician knowledge regarding antibiotic guidelines, lack of access to complete standardised protocols in the clinical areas and on trust intranet. 100% compliance with the peri-procedural antibiotics guidlines. 6-week retrospective data identified that 7.3% patients didn't receive the correct peri-procedural antibiotics. Discussion with Infectious disease and Interventional radiology department was undertaken to complete the missing information in the availabe guidlines like choice of antibiotics in case of allergy to the first line antibiotics group. And duration of post-procedure antibiotics in certain procedures. Based on these discussion a revised guidance was made which adressed the problems with the previous availabe guidlines. The new guidelines were posted in clinical areas and awareness was raised among the junior doctors working in the department regarding the importance of correct antibiotics use. A 2-week retrospective data was collected from patients admitted to the oncology wards from 11 January 2024 to 25 January 2025. We identified 25 patients who had documented interventional procedure done during this period using electronic patient records (Lorenzo). Out of 25 patients only one patient (4%) did not receive the peri-procedural antibiotics as per guidelines which is down from 7.3% at baseline. A change in clinical practice was demonstrated during this project, however, our aim of 100% adherence to the peri-procedural antibiotics guidlines was not met. In the future we recommend other interventions like continued awareness in form of monthly lectures about this issue and adding this to the induction pack of junior doctors in our department.