Perioperative antimicrobial prophylaxis in middle Tennessee, 1989-1990

The patterns of use of perioperative antimicrobial prophylaxis were assessed in a randomly selected sample of short-stay hospitals in middle Tennessee. Overall, 438 procedures (48%) were associated with antimicrobial prophylaxis. Prophylaxis was more common in hospitals with more than 400 beds than in smaller hospitals. Moreover, prophylactic antibiotics were given more often for procedures with a proven indication for prophylaxis than for those without a proven indication (60% vs. 41%, P less than .05); this relationship remained constant regardless of hospital size (common odds ratio, 2.09). However, prophylaxis for procedures with a proven indication was more likely to be given in teaching hospitals than in nonteaching hospitals (odds ratios, 5.41 vs. 1.94). The duration of prophylaxis was less than 2 days for 89% of procedures. A wide variety of agents were used. This study suggests that while improvements have been made over the past decade in decisions about the duration of prophylaxis, considerable variation remains in the selection of the procedures in which such treatment is administered and of the antimicrobial agents used.