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[The use of antibiotics in surgical prophylaxis. The characteristics and consequences]
J Delgadillo1, R Ramírez, J Cebrecos
1Servicio de Farmacología Clínica, Ciudad Sanitaria Universitaria de la Vall d'Hebron, Universidad Autónoma de Barcelona.
Background:
The efficacy of antibiotic prophylaxis in certain surgical procedures has been demonstrated in clinical trials. The present study aimed at getting knowledge on the way how it is used in a certain hospital.
Methods:
In a certain day, all patients receiving antibiotics to prevent a postoperative infection were identified in a medical school hospital. Information on the operative procedure, prescribed antibiotics and clinical course of the patients was recorded.
Results:
Out of 714 patients admitted, 255 (36%) were treated with antibiotics and, of these, 85 were given them to prevent a postoperative infection. In 52% of patients, two or more antibiotics were given. The mean (SD) duration of prophylaxis was 8.4 (8.6) days. It was judged as really indicated in 34 cases (40%). Only in 17 (20%) the first choice antibiotic was selected; in 11 (13%) a preoperative dose of the right antibiotic was administered and only in 3 (3.5%) a preoperative dose of the first choice antibiotic was administered and prophylaxis lasted up to 48 hours.
Conclusions:
The use of antibiotics in surgical prophylaxis in a medical school hospital is inappropriate in more than 95% of cases. The situation in other centres should be quantified and the universally accepted norms of prophylaxis should be implemented.