Prospective study of use of perioperative antimicrobial therapy in general surgery.

Hdl Handle:
http://hdl.handle.net/10147/208823
Title:
Prospective study of use of perioperative antimicrobial therapy in general surgery.
Authors:
Fennessy, Brendan G; O'Sullivan, Martin J; Fulton, Greg J; Kirwan, William O; Redmond, H Paul
Affiliation:
Department of Surgery, Cork University Hospital, Cork, Ireland.
Citation:
Surg Infect (Larchmt). 2006 Aug;7(4):355-60.
Journal:
Surgical infections
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/208823
DOI:
10.1089/sur.2006.7.355
PubMed ID:
16978078
Abstract:
BACKGROUND: Perioperative antimicrobial therapy has demonstrated efficacy in reducing the rate of surgical site infections in clinical trials. With the emergence of antibiotic resistance, the risk of reaction, and the inevitable financial repercussions, use of prophylactic antibiotics is not a panacea, and their misuse may have considerable implications. The aim of this study was to assess the use of antibiotics in the perioperative period in both general and vascular surgery procedures. METHODS: A prospective study was undertaken of 131 patients with a mean age of 43 years (range one month-88 years), of whom 68 (51%) were male, who underwent twenty-seven different general or vascular surgery procedures over a four-week period. Each patient was evaluated from the time of antibiotic commencement through their operative procedure until the treatment was discontinued. RESULTS: A total of 73 patients (54%) received ten antibiotics, with 71 (97%) of these uses being prophylactic. Of the 15 appendectomies performed for uncomplicated appendicitis, the mean number of prophylactic antibiotic doses was 5.3 (range 1-12). Where they were documented, written postoperative directives were not adhered to in 18/27 prescriptions (66%). CONCLUSION: This study has demonstrated a lack of adherence to guidelines in the perioperative administration of antimicrobial agents. In addition, it calls attention to the economic implications of unnecessary prophylaxis.
Language:
eng
MeSH:
Adolescent; Adult; Aged; Aged, 80 and over; Ambulatory Surgical Procedures/*methods; *Antibiotic Prophylaxis; Bacterial Infections/prevention & control; Child; Child, Preschool; Cross Infection/prevention & control; Drug Utilization; Female; Guideline Adherence; Hospitals, University; Humans; Infant; Infant, Newborn; Male; Middle Aged; Perioperative Care/*methods; Physician's Practice Patterns; Practice Guidelines as Topic; Prospective Studies; Surgical Wound Infection/prevention & control
ISSN:
1096-2964 (Print); 1096-2964 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorFennessy, Brendan Gen_GB
dc.contributor.authorO'Sullivan, Martin Jen_GB
dc.contributor.authorFulton, Greg Jen_GB
dc.contributor.authorKirwan, William Oen_GB
dc.contributor.authorRedmond, H Paulen_GB
dc.date.accessioned2012-02-03T15:04:33Z-
dc.date.available2012-02-03T15:04:33Z-
dc.date.issued2012-02-03T15:04:33Z-
dc.identifier.citationSurg Infect (Larchmt). 2006 Aug;7(4):355-60.en_GB
dc.identifier.issn1096-2964 (Print)en_GB
dc.identifier.issn1096-2964 (Linking)en_GB
dc.identifier.pmid16978078en_GB
dc.identifier.doi10.1089/sur.2006.7.355en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208823-
dc.description.abstractBACKGROUND: Perioperative antimicrobial therapy has demonstrated efficacy in reducing the rate of surgical site infections in clinical trials. With the emergence of antibiotic resistance, the risk of reaction, and the inevitable financial repercussions, use of prophylactic antibiotics is not a panacea, and their misuse may have considerable implications. The aim of this study was to assess the use of antibiotics in the perioperative period in both general and vascular surgery procedures. METHODS: A prospective study was undertaken of 131 patients with a mean age of 43 years (range one month-88 years), of whom 68 (51%) were male, who underwent twenty-seven different general or vascular surgery procedures over a four-week period. Each patient was evaluated from the time of antibiotic commencement through their operative procedure until the treatment was discontinued. RESULTS: A total of 73 patients (54%) received ten antibiotics, with 71 (97%) of these uses being prophylactic. Of the 15 appendectomies performed for uncomplicated appendicitis, the mean number of prophylactic antibiotic doses was 5.3 (range 1-12). Where they were documented, written postoperative directives were not adhered to in 18/27 prescriptions (66%). CONCLUSION: This study has demonstrated a lack of adherence to guidelines in the perioperative administration of antimicrobial agents. In addition, it calls attention to the economic implications of unnecessary prophylaxis.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAmbulatory Surgical Procedures/*methodsen_GB
dc.subject.mesh*Antibiotic Prophylaxisen_GB
dc.subject.meshBacterial Infections/prevention & controlen_GB
dc.subject.meshChilden_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshCross Infection/prevention & controlen_GB
dc.subject.meshDrug Utilizationen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGuideline Adherenceen_GB
dc.subject.meshHospitals, Universityen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfanten_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPerioperative Care/*methodsen_GB
dc.subject.meshPhysician's Practice Patternsen_GB
dc.subject.meshPractice Guidelines as Topicen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshSurgical Wound Infection/prevention & controlen_GB
dc.titleProspective study of use of perioperative antimicrobial therapy in general surgery.en_GB
dc.contributor.departmentDepartment of Surgery, Cork University Hospital, Cork, Ireland.en_GB
dc.identifier.journalSurgical infectionsen_GB
dc.description.provinceMunster-

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