A survey of antimicrobial prophylaxis in elective colorectal surgery in New Zealand

In 1988 a survey of New Zealand general surgeons was conducted, by post, on the subject of routine antimicrobial prophylaxis for elective colorectal surgery. Surgeons who gave routine prophylaxis were asked for details of their regimens; those who did not were asked for their reasons. One hundred and seventy-five questionnaires were distributed and 167 were returned. Of these, 124 came from surgeons with a colorectal practice, and 118 of the 124 surgeons satisfactorily completed the questionnaire. Routine antimicrobial prophylaxis was given by 96.6% (114 of 118). Of the 114 surgeons prescribing prophylaxis, one antimicrobial agent was used by 36.8%, two were employed by 53.5% and three or five were used by the remainder. The most commonly used (74.6%) antimicrobial agents were cephalosporins which were prescribed, alone or in combination with a nitroimidazole. The most frequent duration (46.4%) of antimicrobial administration was a combination of both the peri- and postoperative periods. When antimicrobial spectrum, route and duration of administration were all taken into account, 49.1% (56 of 114) were considered to give satisfactory regimens. Excessively protracted administration was the most frequent reason for unsatisfactory classification. The results of this survey demonstrate serious deficiencies in the practice of antimicrobial prophylaxis in elective colorectal surgery. These should be addressed through a programme of continuing education.