[Audit of preoperative antibiotic prophylaxis in a surgical site infections surveillance network]. / Audit des pratiques de l'antibioprophylaxie chirurgicale dans un réseau de surveillance des infections du site opératoire.

ABSTRACT

OBJECTIVE: To evaluate the preoperative antibiotic prophylaxis (PAP) prescriptions in a surgical site infection (SSI) surveillance network. STUDY DESIGN: Auto-evaluative audit in a prospective multicenter cohort included in a surveillance system. PATIENTS AND METHODS: Since 1997, surgical wards in volunteer centers monitored all surgery patients each year during a period of two months. Patients were evaluated for SSI during the 30 days following surgery. Participating centers were asked in 2000 to participate to a PAP practice assessment. For each surgery patient, a questionnaire was completed. The "Guidelines for Antibiotic Prophylaxis Prescription in Surgery" edited in 1999 by the Société française d'anesthésie et de réanimation was used as gold standard. RESULTS: 6109 patients were included in the survey from 34 health care centers and 3881 received PAP. 90% of patients received PAP intravenously and 63% received twice the curative dose. PAP was administered within 90 minutes prior to incision in 70% of cases. 78% of PAP lasted less than 24 hours. PAP indication with regards to the type of surgical procedures was assessed in 4629 patients. PAP guidelines were observed in 1573 (34%) patients 999 patients in whom PAP was not indicated did not receive PAP and 574 received it in compliance with recommended dose and indications. CONCLUSION: Efforts should be made to improve PAP prescription according to standards guidelines.