[Surgical antimicrobial prophylaxis: compliance to guidelines and impact of targeted information program]

Abstract

Objectives: Surgical antimicrobial prophylaxis is used to decrease postoperative wound infection. We assessed the compliance to surgical antimicrobial prophylaxis guidelines in our hospital and the impact of an information program.

Patients and methods: Observational study of clean or clean contamined surgery, during two 3-week periods, separated by a targeted information period. The following data were collected prospectively: prophylaxis indication, antimicrobial agent, timing, dose, route and duration of prophylaxis. Chi square test was used for analysis or Fischer test when available.

Results: Four hundred seventy-seven patients were enrolled - 270 and 207 for each period respectively. For both periods only 49% of prophylaxis was appropriated. When prophylaxis should be administered - 15 and 13% of patients for each period - it was antibioprophylaxy was strictly adequate with recommandations. The most common error was administration timing. Only the choice of antimicrobial agent was optimized after information period.

Discussion: These results are consistent with previous studies. Information program alone have no effect on the good use of antimicrobial for surgical prophylaxis. Only a policy associating organization, restriction and education could improve practices.