Perioperative medicine & outcomes
Guideline Adherence of Perioperative Antibiotics and Surgical Site Infections in Noncardiac Surgery
Main finding · SSIResult — go to the resultRelative risk 1.34 95% CI 1.26–1.43Authors' conclusion
This cross-sectional study found that IDSA guideline nonadherence, including incorrect antibiotic choice and missed intraoperative redosing, was common and associated with increased SSI risk, despite high adherence to SCIP timing metrics.
Study context
- Population
- Adults (≥18 y) undergoing noncardiac surgery with skin incision, 2014–2022, MPOG, NSQIP and Michigan Surgical Quality Collaborative registries
- Participants
- 119,236 adults · 37 institutions
- Exposure
- Nonadherence vs adherence to Infectious Diseases Society of America (IDSA)-defined antibiotic metrics
- Outcome
- SSI (superficial, deep tissue or organ-space infection)
Methodological detailsnationwide, multicentre, hierarchical generalized linear mixed models
- Nationwide
- Multicentre
- Hierarchical generalized linear mixed models
Main finding
SSI
Relative risk
1.34
95% CI 1.26–1.43
Nonadherent vs Adherent
RR 1.34 (95% CI 1.26–1.43)
As reported in the abstract
- SSI overall
- 4.4%
Observational data: associations, not effects.
Further findings
SSI by individual metric nonadherence
| RR (95% CI) | ||
|---|---|---|
| Nonadherence to antibiotic choice | 1.43 (1.33–1.53) | |
| Failure to redose intraoperatively | 1.12 (1.02–1.24) | |
| 0.512Relative risk (log scale) |
Nonadherence rates by IDSA metric
- Any IDSA metric
- 26.1%
- Antibiotic choice
- 13.3%
- Weight-adjusted dosing
- 9.0%
- Timing relative to incision
- 3.0%
- Intraoperative redosing interval
- 4.8%
Original publication
Guideline Adherence of Perioperative Antibiotics and Surgical Site Infections in Noncardiac Surgery. JAMA Netw Open. Published 2 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →