Meijer W S
Department of Surgery, St. Clara Ziekenhuis, Rotterdam, The Netherlands.
Neth J Surg. 1990 Aug;42(4):96-100.
A questionnaire about the current practice of antibiotic prophylaxis in biliary tract surgery was sent to the chairmen of the departments of surgery of 175 hospitals in The Netherlands. The Dutch hospitals are classified into three categories depending on the type of residency in general surgery. Overall, 80 per cent replied. Antibiotic prophylaxis in elective cholecystectomy is given in 76 per cent of the clinics (100/132), and single-dose prophylaxis is employed in 28 per cent of the clinics (28/100). In patients with acute cholecystitis, emergency surgery is the treatment of choice in 108 hospitals (82%). Differences in antibiotic prophylaxis between the three categories of hospitals include the omission of prophylaxis in elective cholecystectomy in 31 per cent of the C-clinics (vs. 10% in A-clinics and 16% in B-clinics), and the use of single-dose prophylaxis in 13 per cent of the B-clinics (vs. 30% of the A-clinics and 31% of the C-clinics). Since prophylaxis for more than 24 hours has no additional effect and peri-operative prophylaxis in acute cholecystitis is mandatory, antibiotic prophylaxis in biliary tract surgery is inappropriate in at least 31 hospitals in The Netherlands (23%).
一份关于荷兰175家医院胆道手术中抗生素预防性使用现状的调查问卷被发送给了各外科主任。荷兰的医院根据普通外科住院医师培训类型分为三类。总体而言，80%的医院进行了回复。76%的诊所（100/132）在择期胆囊切除术中进行抗生素预防，28%的诊所（28/100）采用单剂量预防。在急性胆囊炎患者中，108家医院（82%）选择急诊手术作为治疗方式。三类医院在抗生素预防方面的差异包括：31%的C类诊所（A类诊所为10%，B类诊所为16%）在择期胆囊切除术中未进行预防，13%的B类诊所（A类诊所为30%，C类诊所为31%）采用单剂量预防。由于超过24小时的预防并无额外效果，且急性胆囊炎围手术期预防是必需的，荷兰至少有31家医院（23%）在胆道手术中使用抗生素预防是不合适的。
