Antimicrobial prophylaxis for surgical procedures in Franche-Comte. Compliance with national referential system.

Aim of the study: To evaluate the practice of antibiotic prophylaxis for su rgery in the Franche-Comte region of France. Materials and methods: A total of 36 surgical teams (72 pairs surgeons/anae sthesists) participated in data collection. Five variables describing pract ices concerning antibiotic prophylaxis for surgery were compared to nationa l recommendations: did the surgical procedure require antibiotic prophylaxi s and was it carried out? Was the antibiotic used appropriately? Was the ti ming of the first injection optimal? Was the total duration of the treatmen t correct? Was the dose correct? Results: Among the 687 operations for which data were collected, 513 (74.7% ) that corresponded to class 1 or 2 Altemeier operations for which the Soci ete Francaise d'Anesthesie et Reanimation (SFAR) had drawn up recommendatio ns were analysed in order to answer these questions. The overall frequency of conformity with the regulations was 40% for these 513 operations. Of the 156 patients who did not receive the recommended antibiotic, 133 (85.5%) r eceived an antibiotic with an activity range wider than that of the recomme nded antibiotic. The duration of prophylaxis was longer than recommended in 80 (87.9%) out of the 91 patients for whom the duration of antibiotic prop hylaxis did not respect the recommendations. Conclusions: This prospective surveillance showed that less than 50% of pat ients received an antibiotic prophylaxis that was conformed to the regulati ons. To ensure the efficiency of prophylaxis and to prevent deleterious eff ects, such as the emergence of antibiotic-resistant bacteria, the recommend ations must be regularly respected. Frequent audits of practices should be carried out by the teams responsible for fighting nosocomial infections. (C ) 2001 Editions scientifiques et medicales Elsevier SAS.