PubMed2002
Correct antibiotic prophylaxis reduces the incidence of postoperative infections. 600 questionnaires on perioperative antibiotic prophylaxis were sent to Italian Surgical Departments. Each questionnaire included a series of 17 multi-choice-questions concerning the specific approach of the department to: organization, type, timing, duration, auditing of prophylaxis. 435 departments (72.5%) responded to the questionnaire; 50 of these were blank, so 385 out of 435 (88.5%) were suitable for statistical evaluation. Results were as follows: 90.5% of departments perform some form of prophylaxis under the control, in 90.5% of cases, of surgeons; 89.3% differentiate antibiotics according to class of operation; 67.4% give the antibiotic preoperatively and prefer i.v. injection (61.0%), mostly in the ward (56.2%); in 33.3% of cases the prophylaxis is standard (more than 2 doses), but 55.8% of Italian surgeons do not give a boost-dose in operations longer than 3 h; 54.2% of patients receive a cephalosporin (mostly III generation), with a rotation of molecules in 53.9% of cases; 71.7% of departments register the incidence of infections, but only 43.2% control the patients 30 days after surgery; finally, 54.2% of departments work together with a bacteriology laboratory active 24 hours, while in 81.7% of cases the hospital has an Infection Committee which meets together usually without a programmed date (60.3%). In conclusion, antibiotic prophylaxis in Italian Surgery Departments appears adequate, even though some problems still remain regarding time-dose-duration-schedule, rotation of molecules, excess of cephalosporins, availability of a 24-h bacteriological laboratory and infection surveillance after discharge.