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Audit to evaluate surgical antibioprophylaxis practices in a general hospital Volume 22, issue 4, octobre-novembre-décembre

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Authors
Service pharmacie, Centre hospitalier Avranches‐Granville Équipe opérationnelle d‘hygiène, Centre hospitalier Avranches‐Granville

In the field of continuous quality assurance improvement, the pharmacy department and the Hygiene Operational Unit conducted an audit concerning antibioprophylaxis in our health institution (749 beds). The aim was to assess the compliance between our practices and the "recommandations pour la pratique de l‘antibioprophylaxie en chirurgie, actualisation 1999 de la conférence de consensus de 1992" ‐‐ recommendations for antibioprophylaxis in surgery, 1999 update of 1992 consensus conference ‐‐ (Société française d‘anesthésie et de réanimation ‐‐ SFAR). Antibioprophylaxis protocols could thus be put in place to clearly differentiate prophylactic and curative antibiotherapy. This exhaustive retrospective study concerned 162 patients with surgery over a 2 weeks period. Antibioprophylaxis represented 43.8% of the cases. 49.4% of the prescription totally complied with SFAR recommendations. For 4.9% antibioprophylaxis should not have been prescribed; on the other hand, it should have been prescribed for 12.3% and was not. 98% of the recorded non‐conformities related to the choice of the molecule and 52% to the treatment duration or the number of injections. The most prescribed antibiotics were penicillin associated to betalactamase inhibitors (35.2%) and cefamandole (32.4%). A single dose was injected in 50.7% of the cases; treatment duration overlapped 48 hours for 7% of the patients. Following this audit, protocols were established according to the SFAR recommendations by the pharmacy department and the Hygiene Operational Unit, in collaboration with the surgery and anaesthesia units physicians. These have been validated by the "Comité du médicament et des dispositifs médicaux stériles" ‐‐ Drugs and Sterile Medical Devices Committee ‐‐ and the "Comité de lutte contre les infections nosocomiales" ‐‐ Nosocomial Infections Prevention Committee. A second audit will be carried out one year after the first one and should allow to assess the efficiency of the protocols diffusion on our antibioprophylaxis practices.