EREMIN SR, BROWN SM, ZUEVA LP, VASILYEVA MG, OROURKE EJ; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. K-1201.
Mechnikov State Medical Academy, St.Petersburg, Russian Federation
BACKGROUND: Recent studies have demonstrated a very high rate of surgical site infection (SSI) in Russian Federation (RF). Evidence is accumulating that antimicrobial resistance is a problem in RF as well. Antibiotic usage in surgery (AUS) may be a contributor to both of these problems. METHODS: All operations (N=646) in 2 general surgery units in an academic hospital in St. Petersburg, RF, were followed from 1/2/2000 to 6/23/2000. Chart review was performed at discharge. Inpatient antibiotic prescriptions were extracted from the order sheets. Perioperative antibiotic prophylaxis (PAP) was defined as administration of antibiotic within 2 hours of the surgical incision. Any antibiotics given more than 24 hours after surgery in the absence of SSI (defined according to standard CDC criteria) were considered excessive. RESULTS: PAP was used in only 10.8% of cases. PAP rates were 10.7% (N=526) for clean and clean-contaminated operations and 13.2% (N=76) for contaminated operations. In 95.6% of cases of PAP, antibiotic use exceeded 24 hours, although in 71.4% of those cases, SSI was absent. PAP regimens included metronidazole (MET) (27%), ciprofloxacin (CIP) & MET (25%), CIP (17%), ceftriaxone (13%), gentamicin (GEN) (7%). Rates of excessive use were 47.3% overall, 25.4% (N=240) after clean surgery, 64.3% (N=286) after clean-contaminated surgery. Regimens included ampicillin and oxacillin (25%), GEN (21%), CIP (12%), MET (12%). The mean duration of excessive antibiotic use was 4 days. CONCLUSION: This is the first report of prospectively collected data on AUS in RF. Rates of PAP are extremely low, excess use of antibiotics is very high, duration of PAP is excessive, and regimens are neither standardized nor appropriate for indication. AUS is an important area for quality improvement interventions. Further study is required to determine how best to improve these indicators.
Publication Types:
Keywords:
- Anti-Bacterial Agents
- Antibiotic Prophylaxis
- Clinical Protocols
- Hospitals
- Hospitals, University
- Prescriptions, Drug
- surgery
Other ID:
UI: 102268838
From Meeting Abstracts