Antimicrobial prophylaxis in bowel surgery in The Netherlands.

The guidelines for antimicrobial prophylaxis in various types of bowel surgery (colorectal, biliary and gastroduodenal) in 33 antibiotic formularies used by 89 Dutch hospitals were studied. The majority of the formularies recommended drugs with adequate efficacy against bacteria most frequently associated with surgical wound infection. Amoxicillin/clavulanic acid and first- or second-generation cephalosporins, with or without metronidazole, were recommended most frequently. Recommendations for third-generation cephalosporins and broad-spectrum penicillins were limited. A relatively high proportion (between 52 and 66%) of the formularies recommended multiple-dose regimens.