International Journal of Clinical Pharmacy

, Volume 40, Issue 1, pp 150–159 | Cite as

Efficacy and feasibility of a collaborative multidisciplinary program for antibiotic prophylaxis in clean wound surgery

  • Xinyu Li
  • Hong Chen
  • Shenyin Zhu
  • Yu Liu
  • Jiadan Yang
  • Zhe Yuan
  • Gaoqun Yao
  • Feng QiuEmail author
Research Article


Background Despite national and international guidelines and recommendations, inappropriate prophylactic antibiotic use for clean wound surgery remains a common phenomenon in many Chinese hospitals, causing higher medical costs and bacterial resistance. Objective To improve the prescribing behavior for antibiotic prophylaxis and decrease antibiotic abuse and/or misuse in clean wound surgery. Setting The teaching hospital of a medical university in Southwest China. Methods A collaborative multidisciplinary program involving educational, technical, and administrative strategies was undertaken. It was characterized by a monthly evaluation by clinical pharmacists for randomly selected cases of clean wound surgery, as well as a group discussion attended by correlative personnel, consisting of the administrative staff, experts from the Rational Drug Use Committee, clinical pharmacists and surgeons. Main outcome measure The overall incidence of antibiotic prophylaxis, appropriate antibiotics selection, appropriate initial dosage timing, proper drug combination and the duration of antibiotic prophylaxis were measured. Results from 2009 to 2014, the rate of antibiotic prophylaxis for clean wound surgery declined from nearly 100% to 20–30%. Improvements were also observed in drug selection, timing of the first dose, and dosage and duration for antibiotic prophylaxis. Broad-spectrum antibiotics and enzyme inhibitors have seldom been used after 2011. The medical cost for antibiotics also decreased. Conclusion A collaborative multidisciplinary program, together with a group discussion, is efficient for improving rational antibiotic prophylaxis for clean wound surgery. This study indicates that clinical pharmacists can play a pivotal role in providing the professional evaluation of medical cases, education, and intervention.


Multidisciplinary Antibiotic prophylaxis Clean wound surgery Clinical pharmacist China Antibiotic resistance 



We would like to thank all pharmacists, experts from the Rational Drug Use Committee and administrative staff who participated in this program. We thank all doctors and nurses in our hospital for their support and assistance.


No funding was obtained for this study.

Conflicts of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of PharmacyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
  2. 2.Department of OrthopedicsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
  3. 3.Department of Infectious DiseaseThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina

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