Prescribing practice for antibiotic prophylaxis for 3 commonly performed surgeries in a teaching hospital in Brazil

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.