Inappropriate Use of Antibiotics in Benign Gynecologic Surgery [2L]

INTRODUCTION: Preoperative antibiotic overuse contributes to unnecessary healthcare costs, harmful drug reactions and the creation of drug resistant bacteria. Study objective was to examine inappropriate antibiotic use among laparoscopic gynecologic surgeries and evaluate for targetable trends. METHODS: This is a single center retrospective cohort study. We examined all laparoscopic gynecologic surgeries performed at Lenox Hill Hospital from 2016-2017. There were a total of 1269 cases performed by 63 gynecologists. Cases where antibiotics were indicated were excluded; 794 cases were studied. The two sample t-test was used for continuous variables and a Fisher's exact test or chi-square test were used to compare categorical variables between groups. Results were statistically significant if p < 0.05. Analysis was conducted using SAS v. 9.4. RESULTS: Antibiotics were inappropriately given in 80.3% of all procedures that met criteria. Myomectomies and endometriosis surgeries were more likely to receive antibiotics than adnexal surgeries. Faculty physicians were more likely to appropriately withhold antibiotics than voluntary staff (39.7% vs 11.4%, p < 0.001), oncologists were more likely than benign gynecologists to withhold antibiotics (36.3% vs. 17.5%, p < 0.001) and low volume surgeons were more likely than high volume to withhold antibiotics (35.8% vs. 12.4%, p < 0001). Diabetes and smoking status were both examined and did not appear to influence the decision to administer antibiotics. Low rates of 30 day complications (<1%) were seen among both groups. CONCLUSION: Future directions are to correct the high use of inappropriate antibiotics at our institution and target the groups most at risk.