Heineck I, Ferreira M B, Schenkel E P
Pharmacy School and the Department of Pharmacology-ICBS, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
Am J Infect Control. 1999 Jun;27(3):296-300. doi: 10.1053/ic.1999.v27.a96193.
The contribution of antibiotic prophylaxis to reduce surgical wound infection for some procedures is well known. In spite of extensive knowledge about the effectiveness of antibiotic prophylaxis, its administrative regimens are often inappropriate.
Antibiotic prophylaxis was evaluated in a university-affiliated community teaching hospital. Data were collected from medical records of patients undergoing cholecystectomy, hysterectomy, and herniorrhaphy during a 9-month observation period. A total of 598 procedures were observed. Data were collected about the patient, the surgery, and the antibiotic prophylaxis.
Based on the existing guidelines, the choice to use the prophylactic antibiotic was correct in 75% of the cases. Of these cases, only 3% of the patients received the recommended regimen according to the proposed procedure. It was verified that antibiotic prophylaxis was performed more frequently in patients undergoing open cholecystectomy than laparoscopic cholecystectomy (P =.004). In 46% of the cholecystectomies, more than 4 doses were administered. In hysterectomy, a single dose was used in 54% of the patients, and the antibiotic was administered preoperatively in 80% of the cases. Prophylactic antibiotics were used in 47% of herniorrhaphies.
The surgeons infrequently met the hospital guideline for antibiotic prophylaxis, and compliance varied by type of procedure.
抗生素预防对于某些手术减少手术伤口感染的作用已广为人知。尽管对抗生素预防的有效性已有广泛了解，但其给药方案却常常不恰当。
在一家大学附属社区教学医院对抗生素预防进行评估。收集了9个月观察期内接受胆囊切除术、子宫切除术和疝修补术患者的病历数据。共观察了598例手术。收集了有关患者、手术及抗生素预防的相关数据。
根据现有指南，75%的病例预防性抗生素的选择正确。在这些病例中，只有3%的患者按照建议的手术方式接受了推荐的给药方案。经证实，接受开腹胆囊切除术的患者比接受腹腔镜胆囊切除术的患者更频繁地进行抗生素预防（P = 0.004）。在46%的胆囊切除术中，给药超过4剂。在子宫切除术中，54%的患者使用单剂量，80%的病例在术前给药。47%的疝修补术使用了预防性抗生素。
外科医生很少遵循医院抗生素预防指南，且依从性因手术类型而异。
