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October 20, 2010

Surgical Care Improvement Project Adherence and Postoperative Infections

JAMA. 2010;304(15):1669-1672. doi:10.1001/jama.2010.1461

To the Editor: When the Surgical Infection Prevention Project (which became SCIP) was implemented in 2002, the composite measure of surgical antibiotic prophylaxis (S-INF-Core) for US Medicare patients was 34.4%.1 Although there may be controversy about the best time to initiate prophylaxis, delivery of the antibiotic dose hours before or after incision has been associated with higher surgical infection rates.1 In 2001, almost 10% of Medicare patients received their first prophylactic antibiotic dose 4 or more hours after surgical incision, and many patients continued to receive antibiotic prophylaxis for days after their operation.1,2 In 2009, the US hospital all-payer rate of performance on the S-INF-Core composite measure had improved to 88.4%.2