A national audit of antimicrobial prophylaxis in vascular surgery

A standard questionnaire on antimicrobial prophylaxis for elective and emergency vascular surgery was sent to 262 practising members of the Association of Vascular Surgeons (U.K.). The response rate was 68.3%. A cephalosporin based regime was used in 61.1% of cases while penicillin was used in 39.3% and an aminoglycoside in 6.5%. More than one antibiotic was routinely used in 15.6% of cases, with specific anti-anaerobic cover in 19%. Prophylaxis was used in all cases using a prosthetic graft, but in only 76% of cases using autogenous vein (p < 0.05). A single dose regime was most commonly used for autogenous vein graft (14% vs. 4.5%, p < 0.05), whilst overall a three dose regime was most popular. Some 2.8% of respondents specified a differing regime for supra- and infrainguinal surgery whilst 4.5% modified their regime in emergency cases. Despite its theoretical limitations, a three dose cephalosporin regime is the most commonly prescribed "prophylactic" regime for all forms of vascular surgery in the U.K.