Improving surgical antibiotic prophylaxis in obstetric and gynaecological surgery: a prospective two-cycle quality-improvement clinical audit in a North African tertiary hospital.

@article{hajjar2026improving,
  title = {{Improving surgical antibiotic prophylaxis in obstetric and gynaecological surgery: a prospective two-cycle quality-improvement clinical audit in a North African tertiary hospital.}},
  author = {Ikram Hajjar and Fatma Sellami and Mariem Znati and Aymen Abbassi and Hallouma Ben Fredj and Alia Jebri and Mariem Rahoui and Cyrine Lahmar and Mohamed Abidine and Mariem Garci and Ons Mrad and Nabil Mathlouthi},
  journal = {Infection prevention in practice},
  year = {2026},
  month = sep,
  doi = {10.1016/j.infpip.2026.100600},
  url = {https://europepmc.org/article/MED/42921080},
  note = {CC BY},
}

TY  - JOUR
TI  - Improving surgical antibiotic prophylaxis in obstetric and gynaecological surgery: a prospective two-cycle quality-improvement clinical audit in a North African tertiary hospital.
AU  - Ikram Hajjar
AU  - Fatma Sellami
AU  - Mariem Znati
AU  - Aymen Abbassi
AU  - Hallouma Ben Fredj
AU  - Alia Jebri
AU  - Mariem Rahoui
AU  - Cyrine Lahmar
AU  - Mohamed Abidine
AU  - Mariem Garci
AU  - Ons Mrad
AU  - Nabil Mathlouthi
PY  - 2026
DA  - 2026/09/23
JO  - Infection prevention in practice
DO  - 10.1016/j.infpip.2026.100600
UR  - https://europepmc.org/article/MED/42921080
AB  - Background  Inappropriate surgical antibiotic prophylaxis (SAP), particularly continuation beyond the recommended prophylactic period, increases avoidable antimicrobial exposure and is a key target for infection prevention and antimicrobial stewardship.Methods  A prospective two-cycle targeted clinical audit evaluated 60 eligible procedures included consecutively during active audit observation periods (30 baseline and 30 postintervention) in an obstetric and gynaecological operating theatre of a North African tertiary hospital. Criteria were based on French Haute Autorité de Santé audit tools and Société Française d'Anesthésie et de Réanimation/ Société de Pathologie Infectieuse de Langue Française recommendations. The primary outcome was SAP duration compliant with procedure-specific guidance. The multi-faceted intervention comprised protocol revision and validation, point-of-care access, multi-disciplinary training, visual reminders, role clarification, and surveillance tools.Results  Protocol-governance compliance rose from 30% to 100%; allergy documentation from 67% to 100%; documentation of administration modalities from 3% to 37%; and appropriate antibiotic choice from 57% to 90%. Appropriate SAP duration improved from 10% to 53% (P < 0.001), while SAP continuation beyond 48 h decreased from 83% to 47% (P = 0.006). Documented administration within 60 min before incision decreased from 70% to 47%; this documentation-sensitive indicator was interpreted cautiously because non-compliance could reflect either missing timing information or administration outside the recommended window.Conclusion  A pragmatic multi-disciplinary intervention improved several SAP process indicators and reduced unnecessary continuation beyond the recommended prophylactic period. Further audit cycles should prioritise reliable timing documentation, sustained reduction of prolonged SAP, and feedback of local surveillance data.
SN  - 2590-0889
ER  -