Adherence to Surgical Site Infection Guidelines in Cardiac Surgery in a Tertiary Hospital in Dubai, United Arab Emirates

Purpose: To assess the appropriateness and compliance of antibiotic prophylaxis practices in cardiac surgery in a tertiary hospital in United Arab Emirates (UAE) using three international guidelines. Methods: A retrospective study was performed by reviewing patients' files admitted for cardiac surgery between January 2008 and February 2010. The study evaluated the adherence of health care professionals to three international guidelines with regard to antibiotic prophylaxis. The guidelines were National Surgical Infection Prevention Project (NSIPP), Society of Thoracic Surgeons (STS) and American College of Cardiology/American Heart Association (ACC/AHA). Patients' records were reviewed for antibiotics used for prophylaxis, frequency of administration, timing and number of doses. Results: A total of 92 patients were included in the study. Based on the international guidelines, only 89.1 and 79.3% of the patients received the recommended pre- and post-operative antibiotics, respectively. On the other hand, 93.5% of the patients received the right antibiotic dose while the total duration of all antimicrobial agents used for prophylaxis was concordant with the guidelines (48 h) in only 67.4% of the patients. Conclusion: Adherence to international antimicrobial prophylaxis guidelines for cardiac surgery was found to be suboptimal in the study hospital in Dubai. Various interventions are needed via developing local evidence-based protocols in collaboration with surgeons, and also to strengthen regulations for ensuring adherence to these guidelines.