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Compliance with Local Guidelines for Antibiotic Prophylaxis in Surgery

Published online by Cambridge University Press:  02 January 2015

Montserrat Pons-Busom ,
Margarita Aguas-Compaired ,
Jordi Delás  and
Begoña Eguileor-Partearroyo
Montserrat Pons-Busom*
Affiliation:
Services of Hospital Pharmacy, Hospital del Sagrat Cor, Barcelona, Spain
Margarita Aguas-Compaired
Affiliation:
Services of Hospital Pharmacy, Hospital del Sagrat Cor, Barcelona, Spain
Jordi Delás
Affiliation:
Internal Medicine, Hospital del Sagrat Cor, Barcelona, Spain
Begoña Eguileor-Partearroyo
Affiliation:
Services of Hospital Pharmacy, Hospital del Sagrat Cor, Barcelona, Spain
*
Service of Hospital Pharmacy, Hospital del Sagrat Cor, Viladomat 288, E-08029 Barcelona, Spain
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Abstract

Objectives:

To describe the development and implementation of a local protocol for antibiotic prophylaxis in surgery and to assess compliance with these guidelines using a computer-based system.

Design:

One 5-week prospective period (phase 1) followed by three 1-week, cross-sectional assessments (phases 2, 3, and 4).

Setting:

Pharmacy of a 350-bed acute care teaching hospital in Barcelona, Spain.

Methods:

In phase 1, 395 forms for antibiotic prescribing delivered to the pharmacy were reviewed. Nonadherence was defined as the prescription of an antibiotic (or doses) different from what the protocol specified. In phases 2, 3, and 4, antibiotic prescribing forms for all elective procedures (630 patients) performed during 1-week periods were analyzed.

Results:

A total of 1,047 patients (mean age, 58.9 ± 17.3 years) were included. Cefazolin was administered in 41% of procedures. Overall compliance with antibiotic prescribing forms was 83.3%. There was a statistically significant increase in compliance with guidelines throughout the four phases of the study, from 80.3% in phase 1 to 87.8% in phase 4 (P < .042), as well as adherence to completing forms for surgical procedures, from 51% in phase 2 to 77.6% in phase 4 (P < .001). The main reason for non-adherence was that some procedures had not been included in the protocol in phase 2.

Conclusion:

Surgeons sensitized to the implementation of local antibiotic prophylaxis guidelines showed a high degree of compliance with them, using both the procedure established for antibiotic prescribing and the antimicrobials recommended for particular operations.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 4 , April 2004 , pp. 308 - 312
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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