Appropriateness of antibiotic prophylaxis in gynecologic surgery at Srinagarind Hospital

To evaluate the rate of appropriate prophylactic antibiotic use in gynecologic surgery at Srinagarind Hospital.

Prospective descriptive study.

Srinagarind Hospital, Khon Kaen University, Thailand.

Medical records of 250 women who had undergone gynecologic surgery at Srinagarind Hospital during August 2004 and February 2005 were evaluated. The criteria of appropriate prophylactic antibiotics were based on ACOG recommendation 2001. Data on demographic information, surgery procedure and antibiotic use during surgery were extracted from these medical records and analyzed.

Rate of appropriate prophylactic antibiotic use and type of inappropriate use.

Two hundred and fifty women had undergone gynecologic surgery during the study period. There were 168 total abdominal hysterectomy (TAH), 12 vaginal hysterectomy (VH), 30 salpingooophorectomy (SO), 3 myomectomy, 30 diagnostic laparoscopy and 7 laparoscopic ovarian cystectomy (LOC). Twenty private staff and twenty residents conducted these operations. The overall rate of appropriate prophylactic antibiotic use was 75.2% (95% CI 69.28-80.33). Main type of inappropriate use were multiple doses and indication not fulfilled. The overall rate of appropriate antibiotic prophylaxis among surgeries conducted by private staff was 53.19% (95% CI 42.66-63.46) and the overall rate of appropriate antibiotic prophylaxis among surgeries conducted by residents was 88.46% (95% CI 82.13-93.83). The rate of early post operative infection between both groups was not different (p = 0.529). There was no drug complication in all subjects.

The overall rate of appropriate antibiotic prophylaxis in gynecologic surgery at Srinagarind Hospital was 75.2% (95% CI 69.28-80.33). Residents used prophylactic antibiotics more appropriately than private staff.