Background: Although the high cost and inappropriate use of antibiotics hav
e been documented before, we are not aware of any data on nonsurgical site
infectious morbidity associated with prolonged courses of prophylactic anti
biotics (PA).
Study Design: Data regarding antibiotic orders were collected using a custo
m designed microbiology database in the Surgical Intensive Care Unit of a t
eaching hospital from October 1, 1995 through April 30, 1997. The database
was retrospectively reviewed. The cost of PA in excess of 1 day was calcula
ted. Frequency of bacteremia and line infections were compared in patients
receiving 1 day or less of PA versus more than 4 days of PA.
Results: Sixty-one percent of PA orders were continued for more than 1 day.
Cost of PA beyond 1 day totaled $44,893. Bacteremia and line infection wer
e more frequent in the patients receiving more than 4 days of PA.
Conclusions: There was poor compliance with the protocol of stopping PA at
24 hours. The cost of noncompliance was $44,893. There were more bacteremia
s and line infections in patients with duration of PA of more than 4 days.
(J Am Coil Surg 1999;188:225-230. (C) 1999 by the American College of Surge
ons).