OPTIMIZING THE TIMING OF ANTIMICROBIAL PROPHYLAXIS IN SURGERY - AN INTERVENTION STUDY

The timing of surgical antimicrobial prophylaxis was determined before and after an intervention programme of education of surgeons, anaesth etists and nurses on the subject of antimicrobial drug prophylaxis, an d the subsequent implementation of new protocols of single dose prophy laxis administered within one hour before incision. This prospective s tudy was performed in three surgical departments of a university hospi tal. For comparison, the timing of prophylaxis was also determined in an operating department of a community hospital. The timing improved c onsiderably in the departments of the university hospital where the in tervention was carried out: administration of the first dose within on e hour before incision increased from 39% to 69% in department A and f rom 64% to 80% in department B. Before the intervention, seven out of 16 prophylactic doses were given after inflation of the tourniquet. Af ter the intervention all doses of prophylactic antibiotics were admini stered before inflation of the tourniquet. Initially, the intervals of multidose prophylaxis varied widely. In the second review, single-dos e prophylaxis increased from 21% to 78% in department A and from 31% t o 85% in department B. We conclude that the intervention succeeded in improving the quality of surgical prophylaxis.