Audit of quality of perioperative antimicrobial prophylaxis.

ABSTRACT

OBJECTIVE: To assess the perioperative antibiotic prophylaxis (PAP) prescriptions in a general hospital, Diyarbakir, Turkey. METHOD: An evaluative audit in a prospective cohort included into the study between February and June 2003. All clean and clean-contaminated elective surgical procedures in six surgical wards were recorded. Using the ATC-DDD system, density of antimicrobial use was calculated per procedure. RESULTS: Totally 331 of 391 (84.7%) study procedures received PAP. PAP was indicated in 45% of PAP non-received group and not indicated in 15.1% of received group. Only 18.4% of PAP lasted less than 24 h. The most common prescribed agents were the first generation cephalosporins (85.8%) and aminoglycosides (24.2%). Timing of the initial dose was inappropriate in 135 procedures (40.8%). Only in 44 procedures (13.3%) all steps of PAP were found justified and correct in PAP received group. The mean dosage number of PAP (+/-SD) for per operation was 8.7 +/- 12.5. The density of antimicrobial use was calculated as 330.2 DDD/100-operation. The density of antimicrobial use per operation was 3.3 DDD. CONCLUSION: The density of antimicrobial use in PAP is very high. To improve the appropriateness of PAP, measure of antibiotic use is urgently required.