I. Heineck et al., Prescribing practice for antibiotic prophylaxis for 3 commonly performed surgeries in a teaching hospital in Brazil, AM J INFECT, 27(3), 1999, pp. 296-300
Background: The contribution of antibiotic prophylaxis to reduce surgical w
ound infection for some procedures is well known. In spite of extensive kno
wledge about the effectiveness of antibiotic prophylaxis, its administrativ
e regimens are often inappropriate.
Methods: Antibiotic prophylaxis was evaluated in a university-affiliated co
mmunity teaching hospital. Data were collected from medical records of pati
ents undergoing cholecystectomy, hysterectomy, and hemiorrhaphy during a 9-
month observation period. A total of 598 procedures were observed. Data wer
e collected about the patient, the surgery, and the antibiotic prophylaxis.
Results: Based on the existing guidelines, the choice to use the prophylact
ic antibiotic was correct in 75% of the cases. Of these cases, only 3% of t
he patients received the recommended regimen according to the proposed proc
edure. It was verified that antibiotic prophylaxis was performed more frequ
ently in patients undergoing open cholecystectomy than laparoscopic cholecy
stectomy (P =.004). In 46% of the cholecystectomies, more than 4 doses were
administered. In hysterectomy, a single dose was used in 54% of the patien
ts, and the antibiotic was administered preoperatively in 80% of the cases.
Prophylactic antibiotics were used in 47% of hemiorrhaphies.
Conclusion: The surgeons infrequently met the hospital guideline for antibi
otic prophylaxis, and compliance varied by type of procedure.