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Uniformity of antibiotic prophylaxis in surgical procedures is associated with improvement of timing

Abstract number: 1734_81

Willemsen I., van den Broek R., Bijsterveld T., van Hattum P., Winters M., Andriesse G., Kluytmans J.

Background: The Amphia Hospital is a 1370 bed teaching hospital that was founded in 2001 after a merger of three hospitals. In 2005 the initiative was taken to standardise perioperative antimicrobial prophylaxis (PAP) in surgical procedures.

Objectives: To implement a guideline for PAP, describing the choice of the agent, the dosage and the timing.

Methods: Before and after the implementation the application of PAP was measured. In the new policy cefazolin was the first choice agent, if necessary combined with metronidazol. Clindamycine was preferred as an alternative for patients reporting an allergy to b-lactams. The guideline was approved by all surgeons and anaesthetist and distributed within the hospital. It included for each type of procedure, the antibiotic agent and the dosage.

Results: Before the intervention 153 procedures, from different specialities were observed (in 2 series). Eight different antibiotics in different dosages were used. In 22% of the procedures, PAP was given after the incision. Two months after the intervention 147 procedures were observed (in 3 series). Three different antibiotics, 135 times cefazoline (92%), 11 times metronidazol (7.5%) and one time cefuroxime, were given. All antibiotics were used in the correct dosage. In 12% of the procedures, PAP was given after the incision. This was a significant improvement (p = 0.026).

Conclusion: This project shows that a uniform, simple and clear protocol improves not only the choice and dosage of antibiotics but also the timing. Furthermore, the switch to cefazoline resulted in net savings of at least [euro]40.000 a year.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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