Prophylactic antibiotic use in four Dublin teaching hospitals.

A retrospective study of 266 surgical patients revealed that 55% received antibiotics. Of these, 71% had prophylactic and 29% therapeutic courses. Twenty-five per cent of prophylactic courses were started post-operatively, 65% were continued for more than 24 hours, 28% were administered by an inappropriate route and 10% were started more than two hours pre-operatively. Of all courses of antibiotics ordered, 67% had no record of intended duration on the prescription. In 4% of courses the surgeon's orders were not followed. This study demonstrates widespread suboptimal use of antibiotic prophylaxis in a variety of surgical specialties.