Harbi Hayett, Merzougui Latifa, Barhoumi Mohamed Hafedh, Rebai Hedi, Abdelkefi Sofiene, El Kamel Rafik, Barhoumi Tarek
Direction Régionale de la Santé, Kairouan, Tunisie.
Service d'Hygiène Hospitalière CHU Ibn El Jazzar, Kairouan, Tunisie.
Pan Afr Med J. 2018 Jul 2;30:191. doi: 10.11604/pamj.2018.30.191.14861. eCollection 2018.
Antibiotic prophylaxis (ATBP) is one of the specific measures for the prevention of surgical site infections, whose impact has been quantified in clean or clean-contaminated surgery. Our study aims to evaluate the conformity of ATBP practices and the adherence to the prescribing protocols adopted in our Hospital. We conducted a clinical audit retrospective observational study, evaluating antibiotic prophylaxis practices in our Hospital in the month of March 2015. The primary study endpoint was the overall compliance of the observed practices with the 5 major criteria defined by the French National Authority for Health (FNAH). We followed the guidelines of the French Society of Anesthesia and Intensive Care published in 2010. The study included 150 patients who had undergone surgery in the Department of General Surgery, Orthopaedics and Urology. The overall compliance rate was 33.3%. The compliance with each of the 5 major criteria defined by the FNAH was 74% for the indication; 84% for the time between injection and incision; 60% for the choice of ATB; 89.3% for the dose of the first injection and 72% for the duration of ATBP. The compliance was variable depending on the Department; better compliance was reported in the Department of Urology, in scheduled surgery and when the prescriber was an anesthetist-resuscitator. A global strategy including organization, education and restriction, could lead to a real improvement in the rate of compliance with ATBP practices. Successive audits should be carried out regularly in order to evaluate the impact of the undertaken actions.
抗生素预防（ATBP）是预防手术部位感染的具体措施之一，其在清洁或清洁-污染手术中的影响已得到量化。我们的研究旨在评估我院ATBP实践的合规性以及对所采用的处方协议的遵守情况。我们进行了一项临床审计回顾性观察研究，评估了我院2015年3月的抗生素预防实践。主要研究终点是观察到的实践与法国国家卫生管理局（FNAH）定义的5项主要标准的总体合规情况。我们遵循了2010年法国麻醉与重症监护学会发布的指南。该研究纳入了150例在普通外科、骨科和泌尿外科接受手术的患者。总体合规率为33.3%。对于FNAH定义的5项主要标准中的每一项，适应证的合规率为74%；注射与切开之间时间的合规率为84%；抗生素选择的合规率为60%；首次注射剂量的合规率为89.3%；ATBP持续时间的合规率为72%。合规情况因科室而异；泌尿外科、择期手术以及处方者为麻醉复苏医生时报告的合规情况更好。包括组织、教育和限制在内的全球战略可能会真正提高ATBP实践的合规率。应定期进行连续审计，以评估所采取行动的影响。
