Service pharmacie, Centre régional Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France.
- Key words: antimicrobial prophylaxis, audit, recommendations, surgery.
- Page(s) : 91-8
- Published in: 2002
Although the principles of antimicrobial prophylaxis have been defined over the years, there is still widespread misuse of antibiotics for this purpose.
In 1998, following a three months prospective study of antimicrobial drug use in surgical prophylaxis, new guidelines were implemented. The review was repeated during one month. The aims of the audits were to assess whether the prescription of antibiotics complied with the recommendations and to measure the effect of the intervention. All patients operated during the study periods were included: 145 prescriptions were reviewed during the first audit and 50 during the second one.
In the first audit, compliance with guidelines was only 48%: duration of treatment was inappropriate in 20% of the cases and antibiotics non recommended were prescribed (10%). After intervention, overall compliance with the new protocol did not improve (48%): prophylaxis was used for longer periods in 28% of the cases and the choice of antimicrobial drugs was often inappropriate (20%). However, the timing of prophylaxis was always correct.
This survey proved that there were disparities between the prescription patterns of anaesthetists and the recommendations, and showed the difficulties to implement new guidelines. We did not manage to improve the quality of drug use because there were changes in the anaesthetists' team between the two audits.