Prophylactic use of restricted antibacterials in Czechoslovakia

The prophylactic use of restricted antibacterials in Czechoslovakia was studied. Data from 10 hospitals were collected for approximately 10,000 therapeutic applications of eight restricted antibacterials to 8411 patients. The drugs monitored were oxacillin, kanamycin, gentamicin, carbenicillin, co-trimoxazole, colistin, cephalosporins, and lincomycin/clindamycin. Within one year in the 10 hospitals studied, 943 of 8411 patients (11.2%) received one of the restricted antibacterials for prophylaxis. In the newborn ward, 61.7% of all restricted antibacterial therapy was for prophylaxis; in the gynecology and obstetrics ward, 32.2%. Approximately 14% of patients receiving restricted antibacterials for prophylaxis received two or more, and many of them received nonrestricted antibacterials concurrently. Duration of therapy with these drugs averaged 7.9 days, and 10% of these courses of therapy exceeded 11 days. Although the selection of individual restricted antibacterials for prophylaxis was generally satisfactory, irrational prolongation of therapy was not, indicating that use of these drugs must be supervised carefully.