(270) Knowledge Attitude and Practice of Obstetricians and Gynaecologists towards appropriate surgical antibiotic prophylaxis prescribing in Obstetric and gynaecological surgery in Kuwait: A national cross-sectional survey

Background: Surgical antibiotic prophylaxis (SAP) plays a vital role in obstetric and gynaecological (OB/GYN) surgery to prevent surgical site infections (SSIs). Despite the availability of evidence-based guidelines, studies have highlighted inadequate awareness and suboptimal adherence to these guidelines. However, the knowledge, attitude, and practice (KAP) of OB/GYN surgeons regarding SAP are unknown in Kuwait.

Objectives: This study assessed the overall baseline KAP of gynaecologists and obstetricians to appropriate surgical antibiotic prophylaxis.

Methods:

Design: A national cross-sectional survey among OB/GYN specialists, with various distributions from July 9th to October 10th, 2023. Setting: All public (n=5) and private hospitals (n=21) in Kuwait. Participants: OB/GYN surgeons at a variety of grades in both public and private hospitals. Data Collection: A validated 46-item standardised self-administered KAP questionnaire, in both hard copy and electronic format via Qualtrics. Outcome measures: The primary outcomes were KAP among OB/GYN surgeons based on the American OB/GYN guideline (ACOG), with categorisation using modified Blooms cut-off points.

Results: A total of 89 respondents (response rate: 11.6%) completed the survey, with the majority being female (57.3%, n=51). Most participants were from the public sector (78.7%, n=70), predominantly registrars or specialists (60.1%, n=54). The majority were trained in the Middle East (mainly Egypt and Kuwait) (78.8%, n=70). A significant proportion of participants were unaware of international guidelines (55%, n=49), although 60.7% (n=54) were familiar with local guidelines. Knowledge gaps were evident, particularly regarding SAP indications for different surgery types and appropriate timing and duration. Attitude and practice scores tended toward neutrality attitude and basic practice, with a notable consensus on the necessity for national SAP guidelines in Kuwait and staff education.

Conclusions: This survey revealed insufficient knowledge and neutral attitudes and practices among respondents regarding appropriate SAP. These findings underscore the need for targeted educational initiatives to enhance SAP prescribing practice and guideline adherence in Kuwait's healthcare settings. Further research and development of educational interventions are warranted to bridge these knowledge gaps and improve SAP practices effectively.