309 Antibiotic Usage in Abdominal Surgery Patients in Colorectal, Hepatobiliary and Upper Gastrointestinal Surgery

Abstract Aim Guideline-adherent antimicrobial usage is associated with a 35% relative risk reduction in mortality and superior post-surgical outcomes. This audit assessed: 1/adherence to local antimicrobial surgical prophylaxis guidelines 2/documentation of antimicrobial indication 3/duration 4/ review outcomes. This was re-audited following teaching sessions to surgical departments. Method Data was obtained from drug charts and medical notes of post-surgical inpatients. Data collection periods were: 9/10/23- 20/10/23 (initial audit, 64 patient) and 13/11/23- 17/11/23 (re-audit, 40 patients). Patients were identified from theatre lists for colorectal, hepatobiliary and upper GI surgery. Exclusion criteria included: 1/ age 16 years 2/ long term steroid use or immunocompromised 3/ known colonisation/infection with multidrug resistant organisms. Data was electronically encrypted. Presentation of findings to local surgical and microbiology audit/quality improvement programmes (QIPS) 25/10-7/11/23. Comparison of re-audit findings with the initial audit. Results Following the teaching sessions and presentation: Adherence to local antimicrobial prophylaxis improved from 68.8% to 77.5%. Adequate documentation of antimicrobial duration improved from 78.9% to 85.7%. Adequate documentation of antimicrobial review outcome was 20% on initial audit and 22.5% on re-audit. Adequate documentation of indication for antimicrobial regimen increased from 37% to 60%. Conclusions Compliance with antimicrobial prophylaxis guidelines, documentation of antimicrobial duration and indication improved. However, documentation of antimicrobial review outcome remained poor. Further collaboration with surgical teams, alongside revision of guidelines for modern surgical practice, is required to improve compliance rate. A further audit is planned to assess for sustained improvement in these outcomes.