[Setting appropriate antibiotic prophylaxis before skin incision]

Care should be taken to ensure that antibiotic administration is completed before skin incision during surgery. Therefore, we investigated whether prophylactic antibiotics were being appropriately administered before skin incision in the operating rooms at our institute and whether our discussions with anesthesiologists regarding this issue were effective.

During anesthesia departmental meetings in April 2009, we requested anesthesiologists to ensure appropriate antibiotic administration before incision. Subsequently, we analyzed operating records for February 2009 (n = 142) and May 2009 (n = 132) regarding the time points at which (1) intubation was performed, (2) prophylactic antibiotic administration was initiated and stopped, and (3) operations were initiated.

In approximately 97% of cases, antibiotic administration was initiated before incision. The proportion of cases wherein antibiotic administration was initiated and completed before incision insignificantly increased from 63% to 70% after the discussions with the anesthesiologists. The ratio of cases where antibiotic administration was completed within 30 minutes significantly increased from 79 : 142 to 90 : 132 after the discussions (P = 0.033). This result indicates the importance of administering antibiotics within 30 minutes before incision.

Our discussions for ensuring appropriate antibiotic administration in operating rooms seemed to provide better results for patients.