%0 Journal Article
%T Surgical Antimicrobial Prophylaxis for the Prevention of Surgical Site Infections: A Prospective Cohort Study Should We Follow the Guidelines?
%A Jamal Wadi Al Ramahi
%A Amer Al Zou&#8217
%A bi
%A Doaa Al Btoush
%A Khaled Al Maharmeh
%A Lara Abdulhadi
%A Neveen Kamal
%A Amal Matar
%A Abdel Aziz Saleh
%A Eman Awwad
%A Haya Al Obaidy
%A Ihsan Al Halawani
%A Heba Sarhan
%A Eisa Al Masri
%A Sewar Fraij
%A Mohammed Al Zaben
%A Hamza Al Masaeid
%A Maha Al Mansour
%A Asalah Awadeh
%A Dania Abu Kaf
%A Mayes Al Ahmad
%A Lian Odeh
%J Advances in Infectious Diseases
%P 388-399
%@ 2164-2656
%D 2025
%I Scientific Research Publishing
%R 10.4236/aid.2025.152031
%X <b>Background</b>: Surgical antimicrobial prophylaxis (SAP) is a cornerstone for reducing surgical site infections (SSIs), yet its implementation remains inconsistent. This study evaluates the impact of adherence to local SAP guidelines (GDSAP) versus surgeon-directed practices (SDSAP) on SSI outcomes. <b>Methodology</b>: A prospective cohort of 827 surgical patients in two Jordanian hospitals was evaluated. After filtering for eligibility and outcome availability, 464 patients were analysed&#8212;232 in each group (GDSAP vs. SDSAP). SSI by day 90 was the primary outcome. Data were collected through patient monitoring, medical records, and post-discharge surveillance. Missing data (&lt;5%, except SSI at 33.4%) were imputed using Multivariate Imputation by Chained Equations (MICE). Logistic regression identified SSI predictors. <b>Results</b>: Groups were demographically and clinically balanced. Post-discharge antibiotic use was higher in SDSAP (75%) compared to GDSAP (59%) (P &lt; 0.001). SSIs were more frequent in the SDSAP group (16%) than in GDSAP (7.4%) (P = 0.004; OR = 3.12; RR = 1.27). Multivariate analysis revealed anaemia (OR = 2.86), multiple comorbidities (OR = 1.93), and BMI (OR = 1.01) as significant SSI predictors. GDSAP adherence independently predicted lower SSI risk (OR = 0.41; P = 0.006). <b>Conclusion</b>: Adherence to SAP guidelines has significantly reduced SSI rates and reflects a decrease in post-discharge antimicrobial overuse. Hospitals should implement tailored SAP protocols and multidisciplinary stewardship to ensure safer surgical outcomes.
%K Surgical Site Infection
%K Surgical Antimicrobial Prophylaxis
%K Guideline Adherence
%K Antibiotic Stewardship
%K Low- and Middle-Income Countries
%K Infection Control
%K SSI Risk Factors
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=143804