Evaluation of surgical antimicrobial prophylaxis compliance: A multicenter point prevalence study

Background: This study aimed to determine the frequency of compliance with surgical antimicrobial prophylaxis (SAP) in Turkey and to identify the causes for noncompliance. Methods: This multicenter, prospective, point prevalence study was conducted in 8 hospitals from different regions of Turkey. Patients over 18 years who underwent SAP in all hospital surgical units were included. The SAP compliance assessment was carried out under 5 headings: unnecessary prophylaxis, inappropriate drug choice, prolonged prophylaxis, inappropriate dose interval, and inappropriate dosage. Results: The study included 541 patients from 8 centers. About 52.7% (n = 285) were female and the median age was 54 years (min-max: 18-94). Orthopedics (23.7%) and general surgery (22.2%) were the most common specialties. SAP compliance was 14%. The specialty with the highest rate of inappropriate SAP was orthopedics (97%) and the lowest rate was in ophthalmology (25%). The most common causes of inappropriate SAP were prolonged prophylaxis (92.0%) and inappropriate dose interval (84.6%). Multivariate logistic regression analysis revealed that prolonged surgical time, American Society of Anaesthesiologists (ASA) score 3, and some specialties increased the risk of noncompliance with surgical prophylaxis. Conclusions: This study showed that SAP compliance is low in Turkey and that inappropriateness is caused mostly by prolonged and inappropriate antimicrobial use. © 2025 Association for Professionals in Infection Control and Epidemiology, Inc.