Optimizing antibiotic management for patients with acute appendicitis: A quality improvement study (26 February 2024)

Summary

To decrease surgical site infections after appendectomy for acute appendicitis, preoperative broad-spectrum antibiotics are often used in clinical practice. However, this treatment strategy has come under scrutiny because of increasing rates of antibiotic-resistant infections.

This multisite quality improvement project aimed to decrease the treatment of uncomplicated acute appendicitis with piperacillin-tazobactam without increasing the rate of surgical site infections. The intervention had two distinct components:

1. Updating electronic health record orders to encourage preoperative administration of narrow-spectrum antibiotics.
2. Educating surgeons and emergency department clinicians about selecting appropriate antibiotic therapy for acute appendicitis.

Patient demographics, clinical characteristics and outcomes were compared six months before and after implementation of the quality improvement intervention.

The intervention successfully decreased piperacillin-tazobactam administration without increasing the rate of surgical site infections in patients with acute appendicitis.