Practice of a Pharmacy-Led Multidisciplinary Collaborative Closed-Loop Management Model in the Prophylactic Use of Antimicrobial Agents During the Perioperative Period of Orthopedic Class I Incision Surgeries

Objective: To evaluate the efficacy of a pharmacy-led multidisciplinary collaborative closed-loop management model in improving the rational use of perioperative prophylactic antimicrobial agents in orthopedic Class I incision surgeries. Methods: A pharmacy-led multidisciplinary collaborative closed-loop management model involving pharmacy, clinical departments, medical administration, and hospital infection control was established to address irrational prophylactic antimicrobial use in orthopedic Class I incision surgeries at our hospital. Medical records of all patients undergoing Class I incision surgeries in the orthopedic department from January 2022 to December 2024 were retrospectively reviewed. The intervention effects were assessed by comparing six key aspects before and after implementation: indications for antimicrobial use, drug selection, timing of administration, dosage and frequency, combination therapy, and duration of prophylaxis. Rseults: Following the intervention, the prophylactic antimicrobial use rate decreased from 60.51% to 53.48% (P< 0.05). The compliance rate for appropriate indications increased from 94.37% to 95.87% (P> 0.05). The rational drug selection rate improved from 61.03% to 97.46% (P < 0.05). The rational dosage and frequency rate rose from 83.57% to 100% (P < 0.05). The rational combination therapy rate increased from 96.24% to 99.84% (P < 0.05). The compliance rate for optimal timing of administration improved from 81.69% to 90.32%, and the rational duration of prophylaxis increased from 12.68% to 71.43% (P < 0.05). Conclusion: The pharmacy-led multidisciplinary collaborative closed-loop management model effectively enhances the rational use of perioperative prophylactic antimicrobial agents in orthopedic Class I incision surgeries, demonstrating high feasibility and broad applicability.