Nosocomial infections significantly contribute to a patient’s morbidity and mortality, increasing healthcare costs. While previous research has assessed the effect of oral hygiene on the prevention of nosocomial infections and postoperative complications, few guidelines exist that offer evidence-based recommendations on pre- or peri-operative oral hygiene in the surgical setting. The Philippine Surgical Infection Society set out to develop a set of guidelines that provide evidencebased recommendations on oral hygiene for improving surgical outcomes for adoption in the Philippines. Six clinical questions defined the scope of the guidelines. A systematic review was performed to provide the evidence base to develop the recommendations. A consensus meeting participated by 15 representatives from 13 specialty surgical societies and societies concerned with infection control was conducted using the modified Delphi technique to finalize the set of recommendations. A consensus guideline with sixteen recommendations on the use of oral hygiene to improve surgical outcomes is presented for adoption and implementation.

Objective. This study aimed to assess compliance with current best practice guidelines on the use of antibiotics in the Department of Surgery in the Philippine General Hospital and to determine the impact of the dissemination of an institution-based guideline on compliance and on patient outcomes. Methods. Two antibiotic use surveys were performed 4 weeks before and 4 weeks after the implementation and dissemination of the PGH Surgical Antibiotic Use Guidelines in the Department of Surgery. The medical records of eligible patients were reviewed regarding patient and case characteristics, details on the administration of antibiotics and the collection of specimen for culture studies. Data relating to the occurrence of surgical site infection within 30 days of the operation was extracted. Compliance with antibiotic use guidelines was assessed for each case. The compliance rates in the pre- and post-intervention periods were compared. Results. The study included a total of 477 patients, 213 in the pre-implementation and 264 in the post-implementation period. Compared with the pre-intervention period, rates of compliance with guidelines improved for all parameters in the post-implementation period except for correct dosing. The greatest improvement was seen in the selection of the recommended drug, and proper duration. There was modest improvement in the timing of the preoperative drug administration. There was poor compliance with recommendations for appropriate specimen collection for culture studies, with marked improvement in collection in the pediatric group post-intervention. Overall, the in-hospital SSI rate was reduced from 6.8% to 1.1%, while there was little change in the 30-day SSI rate, post-intervention. Conclusion. A simple intervention to raise awareness of institutional guidelines on antibiotic use in the surgical setting lead to a modest improvement on overall compliance, although rates of total compliance with all relevant guidance on antibiotic use, choice, dose, timing and duration remained low. The impact on surgical site infection rates based on such compliance was modest.
Anti-Bacterial Agents