A point-prevalence study on surgical antibiotic prophylaxis in a tertiary care hospital and evaluation of the use of the surgical prophylaxis guide
Abstract number: R2421
Kocak Tufan Z., Bulut C., Kaya Kilic E., Sonmezer C., Altun S., Temocin F., Tulek N., Kinikli S., Demiroz A.
Objectives: Inappropriate use of antimicrobial drugs is associated with increased hospital expenditure, emergence of resistant bacteria and unnecessary side-effects. Concerning this, antibiotic stewardship is among the main concerns of the hospital infection control programmes. A "surgical antibiotic prophylaxis guide" was established in our hospital in 2008. The aim of this study was to investigate the point prevalence of antibiotic prophylaxis in surgery clinics and to evaluate the appropriateness of the antibiotic use.
Methods: The study was conducted in the Ankara Training & Research Hospital, a 670-bed tertiary care teaching hospital. The hospital contains 23 operation rooms and over 15.000 operations are performed within a year. On the 16th of December 2010 infectious diseases consultants went to the operation rooms of eight surgery clinics (Plastics & reconstructive surgery, general surgery, ophthalmology, ear-nose-throat, orthopaedics, urology, obstetrics & gynaecology (O&G) and neurosurgery) and investigate the prophylactic antibiotic regimen before the surgeries. The duration of the intended use of antibiotics after the surgeries was also included in the questionnaire.
Results: Seventy-two of 196 hospitalized surgery patients were underwent different kind of surgeries. 50 of them (69.4%) were using prophylaxis. Cefazolin (45.8%), sulbactam-ampicillin (11.1%) and ceftriaxone (6.9%) were the most frequent antibiotics used for prophylaxis. In four patients (5.6%) combined antibiotics (metronidazole plus any antibiotics above) were used. 30.6% of the patients did not get any prophylaxis. The mean duration of the antibiotic use was 2.7 (122) days and the intended use of the antibiotic prophylaxis after the surgeries was 3.8 (110) days. 45 (62.5%) of the antibiotic prophylaxis regimens were inappropriate according to the guidelines. The reasons for the inappropriateness were as follows: wrong antibiotic (8.9%), wrong doses and duration (84.4%) and no antibiotics in spite of the need (6.7%).
Conclusion: The current study showed a high percentage of inappropriate surgical prophylaxis regimens in our hospital. The main problems about the inappropriate prophylactic antibiotic use were the dose and the duration (84.4%). The chosen antibiotic was 91.1% right. As conclusion we suggest that the hospital infection control programmes must include the follow up of the use of established guidelines, just introducing them seems to be not efficient.
|Session name:||Abstracts of 21st ECCMID / 27th ICC|
|Location:||Milan, Italy, 7 - 10 May 2011|
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