Guideline Adherence of Post-Exposure Prophylaxis and Factors Associated with Vaccine Series Completion in Patients Presenting to the Emergency Department with Rabies-Risk Exposure
Retrospective study reveals low guideline adherence and underuse of immunoglobulin in rabies-exposed emergency patients, highlighting the need for improved protocol compliance.
Key Points
To evaluate emergency department adherence to national rabies post-exposure prophylaxis guidelines and identify factors associated with completion of the rabies vaccine series.
Retrospective review of 343 patients presenting with rabies-risk exposures to a hospital emergency department in Turkey between June 2025 and May 2026.
Guideline adherence was assessed against the 2019 Turkish Ministry of Health Rabies Prophylaxis Guideline, evaluating vaccination courses, immunoglobulin delivery, and presentation timing.
Between-group comparisons were conducted using the Mann-Whitney U, Kruskal-Wallis, chi-square, and Fisher's exact tests.
Overall guideline adherence for post-exposure prophylaxis was 54.5%, with rabies immunoglobulin administered in only 14.0% of Category III/IV exposures where it was indicated.
The complete rabies vaccine series was completed by 72.9% of patients, and a history of prior prophylaxis was the only evaluated variable significantly associated with series completion (p=0.014).
Delays in emergency department presentation were significantly linked to rural residence, atypical exposure types, and milder wound categories.