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

Year: 2026

Type: article

Abstract: 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: = 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.

Source: Infection Prevention in Practice

DOI: 10.1016/j.infpip.2026.100600