TPTh 7.07 The Effectiveness of Systematic Interventions Leading to Change in Practice: A Three-Cycle Clinical Audit on Antibiotic Use in Acute Pancreatitis
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ID: 323915
2026
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Abstract
Abstract Aims Despite prevailing recommendations advising against prophylactic antibiotics use in acute pancreatitis, inappropriate prescribing remains common. This study aimed to evaluate antibiotic prescribing practices in acute pancreatitis within a UK tertiary upper gastrointestinal surgery unit and to assess the impact of targeted educational interventions. Methods A prospective audit was conducted including all patients admitted with acute pancreatitis over 30 days during September 2023, August 2025 and November 2025. Appropriateness of antibiotic prescribing was assessed against NICE and BSG recommendations. Awareness posters were introduced after first cycle, complimented by targeted teaching imparted during weekly junior doctors teaching sessions; following the second cycle. Results 87 patients were included in three cycles: 37, 27, and 23 patients respectively. Antibiotics were prescribed in 45.9% (n=17/37) vs 37% (n=10/27) vs 47.8% (n=11/23) patients. Inappropriate prescribing reduced significantly (p for trend = 0.016) through the study; cycle one 52.9% (n=9/17) to cycle two 30% (n=3/10) and final cycle 9.1% (n=1/11). Documentation of antibiotic indication improved to 100% in the final cycle, with biliary tract infection being the most common appropriate indication. Mean antibiotic duration in the third cycle was 5.3 days with intravenous cefuroxime and metronidazole being the most frequently prescribed antibiotics. Conclusions Study demonstrates that sustained, low-cost educational interventions addressing diagnostic uncertainty and improving confidence in distinguishing inflammatory responses from true infection significantly reduced inappropriate antibiotic prescribing in acute pancreatitis. These easily reproducible and implementable interventions represent an effective and scalable approach to antimicrobial stewardship and warrant their wider adoption across acute surgical services.
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openalex_W7172484882
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| Authors | Shakir Mohamed, Sashwika S Venkatraman, Ola Mohammed, Ilayaraja Rajendran |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.497
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| URL | |
| Keywords | Keywords not found |
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