• Ann Acad Med Singap · Nov 2022

    National surgical antibiotic prophylaxis guideline in Singapore.

    • Wei Teng Gladys Chung, Humaira Shafi, Jonathan Seah, Parthasarathy Purnima, Taweechai Patun, Kai Qian Kam, Valerie Xue Fen Seah, Rina Yue Ling Ong, Li Lin, Robin Sing Meng Choo, Pushpalatha Lingegowda, Cheryl Li Ling Lim, Jasmine Shimin Chung, Nathalie Grace S Y Chua, Tau Hong Lee, Min Yi Yap, Tat Ming Ng, and Jyoti Somani.
    • Pharmacy Department, National University Hospital, Singapore.
    • Ann Acad Med Singap. 2022 Nov 1; 51 (11): 695711695-711.

    IntroductionInstitutional surgical antibiotic prophylaxis (SAP) guidelines are in place at all public hospitals in Singapore, but variations exist and adherence to guidelines is not tracked consistently. A national point prevalence survey carried out in 2020 showed that about 60% of surgical prophylactic antibiotics were administered for more than 24 hours. This guideline aims to align best practices nationally and provides a framework for audit and surveillance.MethodThis guideline was developed by the National Antimicrobial Stewardship Expert Panel's National Surgical Antibiotic Prophylaxis Guideline Development Workgroup Panel, which comprises infectious diseases physicians, pharmacists, surgeons and anaesthesiologists. The Workgroup adopted the ADAPTE methodology framework with modifications for the development of the guideline. The recommended duration of antibiotic prophylaxis was graded according to the strength of consolidated evidence based on the scoring system of the Singapore Ministry of Health Clinical Practice Guidelines.ResultsThis National SAP Guideline provides evidence-based recommendations for the rational use of antibiotic prophylaxis. These include recommended agents, dose, timing and duration for patients undergoing common surgeries based on surgical disciplines. The Workgroup also provides antibiotic recommendations for special patient population groups (such as patients with β-lactam allergy and patients colonised with methicillin-resistant Staphylococcus aureus), as well as for monitoring and surveillance of SAP.ConclusionThis evidence-based National SAP Guideline for hospitals in Singapore aims to align practices and optimise the use of antibiotics for surgical prophylaxis for the prevention of surgical site infections while reducing adverse events from prolonged durations of SAP.

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