# Evaluation after implementation of chemical bowel preparation for surgical site infections in elective colorectal cancer surgery and role of antimicrobial stewardship pharmacist: Retrospective cohort study

## TL;DR

This study found that chemical bowel preparation and laparoscopic surgery reduced surgical site infections in colorectal cancer patients, with antimicrobial stewardship pharmacists playing a key role in implementing these changes.

## Contribution

The study demonstrates the effectiveness of chemical bowel preparation and the impact of antimicrobial stewardship pharmacists in reducing surgical site infections.

## Key findings

- Female sex, laparoscopy, and chemical bowel preparation were associated with reduced surgical site infections.
- Modifying the clinical pathway led to a significantly shorter postoperative hospital stay.
- Antimicrobial stewardship pharmacists helped implement and validate the effectiveness of chemical bowel preparation.

## Abstract

We evaluated the predictive factors for surgical site infections (SSIs) in elective colorectal cancer surgery and the role of antimicrobial stewardship (AS) pharmacists in modifying the clinical pathway.

Between February 2017 and January 2022, 414 elective colorectal cancer surgeries were performed. The results of multivariate analysis by SSI incidence were adjusted odds ratio (aOR): 0.45; 95% confidence interval (CI): 0.22–0.96 (P = 0.039) for sex (female), aOR: 0.27; 95% CI: 0.13–0.58 (P < 0.001) for laparoscopy, aOR: 0.42; 95% CI: 0.19–0.91 (P = 0.029) for chemical bowel preparation. The median (interquartile range) postoperative length of stay was 12 (10.0–18.5) vs. 10 (9.0–13.0) days before and after the clinical pathway was modified (P < 0.001).

The role of AS pharmacists was primarily to conduct a literature search to explore whether SSIs could be ameliorated by pharmacotherapy, coordinate the addition of chemical bowel preparation, and epidemiologically confirm their effectiveness.

The online version contains supplementary material available at 10.1186/s40780-024-00333-1.