Perioperative Antibiotic Prophylaxis in Clinical
The aim of the study was to determine the efficiency of perioperative antibiotic prophylaxis in surgical patients.Material and methods. During the period between January and December, 2005, eight surgical Departments were subject to investigation, considering surgical wound infections following selected procedures: 3 orthopedic departments, 3 general surgery departments, and two vascular surgery departments. Based on obtained results the following parameters concerning perioperative antibiotic prophylaxis were evaluated: was the procedure performed with antibiotic prophylaxis?; type of chemotherapeutic agent used, and duration of prophylaxis.Results. Inguinal hernia repair procedures were most often performed without antibiotic (33% of procedures). The statistically significant higher incidence index of surgical wound infections was confirmed in case of cholecystectomy without (18.8 vs 2%). In case of vascular procedures cefuroxime was used in 8 doses. In case of hip or knee joint endoprosthesis surgery cefazolin was administered in five doses. In 70% of cholecystectomy and hernial repair procedures one dose of cefazolin was used. Considering colorectal operations the following antibiotics were used: 6 doses of cefazolin in 36% of cases, and 8 doses of amoxicillin with clavulanic acid. Twenty-five percent of colorectal procedures required the administration of amoxicillin with clavulanic acid and metronidazolConclusions. Analysis demonstrated that in spite of the many guidelines elaborated by scientific associations concerning perioperative antibiotic prophylaxis, the above-mentioned are rarely administered according to clinical practice.
- Bratzler DW, Houck PM: Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis 2004; 38: 1706-15.
- Bratzler DW, Hunt DR: The surgical infection prevention and surgical care improvement project: national initiatives to improve outcomes for patients having surgery. Clin Infect Dis 2006; 43: 322-30.
- Weber WP, Marti WR, Zwahlen M et al.: The timing of surgical antimicrobial prophylaxis. Ann Surg 2008; 247: 918-26.[WoS]
- Horan TC, Gaynes RP, Martone WJ et al.: CDC definitions of nosocomial surgical site infections, 1992: a modifications of CDC definitions of surgical wound infections. Am J Infect Control 1992; 20: 271-74.[Crossref]
- Takesue Y, Mikamo H, Arakawa S et al.: Guidelines for implementation of clinical studies on surgical antimicrobial prophylaxis. J Infect Chemother 2008; 14: 172-77.
- Bratzler DW, Houck PM, Richards C et al.: Use of antimicronial prophylaxis for major surgery: baseline results from the National Surgical Infection Prevention Project. Arch Surg 2005; 140: 174-82.
- Kritchevsky SB, Braun BI, Bush AJ et al.: The effect of a quality improvement collaborative to improve antimicrobial prophylaxis in surgical patients. Ann Intern Med 2008; 149: 472-80.
- Stewart AH, Eyers PS, Earnshaw JJ: Prevention of infection in peripheral arterial reconstruction: a systematic review and meta-analysis. J Vasc Surg 2007; 46: 148-55.[WoS]
- Hawn M, Itani KM, Gray SH et al.: Association of timely administration of prophylactic antibiotics for major surgical procedures and surgical site infection. J Am Coll Surg 2008; 206: 814-21.
- Tocchi A, Lepre L, Costa G et al.: The need for antibiotic prophylaxis in elective laparoscopic cholecystectomy: a prospective randomized study. Arch Surg 2000; 135: 67-70.
- Biswas S: Elective inguinal hernia repair with mesh: is there a need for antibiotic prophylaxis? A review. World J Surg 2005; 29: 830-36.[Crossref]
- Jawień M, Wojkowska-Mach J, Rozanska A et al.: Surgical site infection following cholecystectomy: comparison of procedures performed with and without laparoscope. Int J Infect Contr 2008; 4: 1-5.
- Catarci M, Mancini S, Gentileschi P et al.: Antibiotic prophylaxis in elective laparoscopic cholecystectomy: Lack of need or lack of evidence? Surg Endosc 2004;18: 638-41.[Crossref]
- Sanabria A, Dominguez LC, Valdivieso E et al.: Prophylactic antibiotic for mesh inguinal hernioplasty: a meta-analysis. Ann Surg 2007; 245: 392-96.
- Gravante G, Venditti D, Filingeri V: The role of single-shot antibiotic prophylaxis in inguinal hernia repair. Ann Surg 2008; 248: 496-97.[WoS]
- Aufenacker TJ, Koelemay MJ, Gouma DJ et al.: Systematic review and meta-analysis of the effectiveness of antibiotic prophylaxis in prevention of wound infection after mesh repair of abdominal wall hernia. Br J Surg 2006; 93: 5-10.
- AlBuhairan B, Hind D, Hutchinson A: Antibiotic prophylaxis for wound infections in total joint arthroplasty. J Bone Joint Surg 2008; 90: 915-19.[WoS]
- Kobayashi M, Mohri Y, Inoue Y et al.: Continuous follow-up of surgical site infections for 30 days after colorectal surgery. World J Surg 2008; 32: 1142-46.[WoS]
- Geroulanos S, Marathias K, Kriaras J et al.: Cephalosporins in surgical prophylaxis. J Chemiother 2001; 13: 23-26.
- Bandyk DF: Vascular surgical site infection: risk factors and preventive measures. Semin Vasc Surg 2008; 21: 119-23.[PubMed][Crossref]
- Sadat U, Chaudhuri A, Hayes PD et al.: Five day antibiotic prophylaxis for major lower limb amputation reduces wound infection rates and the length on in-hospital stay. Eur J Vasc Endovasc Surg 2008; 35: 75-78.[WoS]