ANTIBIOTIC-PROPHYLAXIS FOR SURGICAL-PROCEDURES - A SURVEY FROM AN ITALIAN UNIVERSITY HOSPITAL

The aims of this study were: 1) to evaluate the surgical prophylaxis r egimens adopted by surgeons of the University Hospital of the Faculty of Medicine and Surgery of the 2nd University of Naples during the per iod January-March 1996; 2) to compare uses of antibiotic prophylaxis c arried out in surgical departments to standard international guideline s; 3) to assess the cost of surgical prophylaxis. Data from 1,085 surg ical patients from January 1, 1996 to March 31, 1996, were collected, reporting surgical department, type of surgery, antibiotics used, dosa ge, and length of the prophylactic treatment. Collected data underwent computer-assisted evaluation and comparison to the international guid elines. Four-hundred and twenty-five patients with concomitant disease s, who did not meet inclusion criteria into standard guidelines, were excluded from the study. The remaining patients (N = 660) underwent cl ean or clean-contaminated surgical procedures. Two-hundred and twenty patients underwent clean surgical procedures, with prophylactic antibi otic treatment lasting from 1.1 +/- 0.3 to 4.6 +/- 2.8 days. Four-hund red and forty patients underwent a clean-contaminated surgical procedu re, with antibiotic prophylaxis lasting from 3.6 +/- 2.4 to 5.2 +/- 3. 7 days. Third generation cephalosporins were the most frequently used antibiotics both in patients undergoing clean (163 patients = 74.1%), and clean-contaminated surgical procedures (321 patients = 73%). The r esulting costs were about ten-fold higher than costs of antibiotic pro phylaxis carried out according to international guidelines. In conclus ion, our research highlights the habit of non-compliance with standard guidelines for antibiotic prophylaxis both in terms of drug choice an d treatment duration.