JAC Advance Access originally published online on November 12, 2007
Journal of Antimicrobial Chemotherapy 2008 61(1):214-218; doi:10.1093/jac/dkm406
Original research |
Adherence to guidelines for antibiotic prophylaxis in general surgery: a critical appraisal
1 Department of Pharmacology, Medical School, University of Athens, Athens, Greece 2 Laboratory of Hygiene and Epidemiology, Medical School, University of Athens, Athens, Greece 3 1st Propaudeutic Surgical Department, Medical School, University of Athens, Athens, Greece
Received 24 April 2007; returned 2 July 2007; revised 11 September 2007; accepted 2 October 2007
* Corresponding author. Tel: +30-210-6468674; Fax: +30-210-7757545; E-mail: chtourmou{at}med.uoa.gr or christostourmousoglou{at}hotmail.com
Objectives: To evaluate the adherence of general surgeons to guidelines for antimicrobial prophylaxis. This study was held from January 2000 until October 2000 in a General Surgery Clinic in a hospital in Athens, Greece.
Methods: Eight hundred and ninety-eight patients were enrolled and operated on electively. Questionnaires concerning demographic data, health status, type of surgery (clean and clean-contaminated) and parameters of antibiotic prophylaxis (antibiotic choice, route, dose, timing of first dose, timing of operative redosing and duration of prophylaxis) were completed.
Results: Of the patients, 44.8% underwent a clean surgical operation and 55.2% underwent a clean-contaminated surgical operation. Inguinal hernia repair and laparoscopic cholecystectomy were the commonest operations in each category. Second-generation cephalosporins were the most frequently prescribed antibiotics, in 67%. Although, only 78.5% of procedures required prophylaxis, it was administered in 97.5%, so it was not justified and inappropriately administered in 19%. It was revealed that 100% of patients received antibiotic prophylaxis on time. The choice of antimicrobial agent was appropriate in 70% and the duration of prophylaxis was optimal in 36.3%. The overall compliance rate of surgeons with guidelines for antibiotic prophylaxis was 36.3%.
Conclusions: Adherence to separate aspects of guidelines for surgical prophylaxis has to be improved. The duration of antibiotic prophylaxis was the main parameter of interest. Interventions have to be made about the development, distribution and adoption of adequate guidelines in collaboration with surgeons.
Keywords: compliance , antimicrobial prophylaxis , surgical operations
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