Pattern of prophylactic use of antibiotics in six surgical departments of a teaching hospital in Jerusalem.

The prophylactic use of antibiotics for various surgical procedures was studied in six surgical departments of the Hadassah University Hospital over an 18-month period between January 1972 and June 1973. A total of 7,339 patients was discharged from the six departments during this period. Antibiotics had been used prophylactically in 17.7% of these patients and in 20.4% of the 6,313 patients in whom there was no evidence of infection on admission. The rate of prophylactic use varied from 12.8 to 47.8% in different departments. Different prophylactic regimes were used in the various departments, but there was a tendency for the same regime to be used within one department, irrespective of the nature of the surgical procedure. The antibiotics were usually started postoperatively. The duration of the prophylactic courses varied but there was a general tendency to continue for more than five days, often up to 10 or more days. The frequency of use seemed to be related to the presence of factors regarded as carrying a high risk of infection, such as advanced age, operation through a contaminated field and the presence of malignancy. The association between prophylactic use and subsequent wound infection was examined. The importance of continuous surveillance of the prophylactic use of antibiotics and the role of the infection-control unit in this surveillance is stressed.