title: Systemic prophylactic antibiotics: need the 'cost' be so high?
abstract: To assess compliance with accepted principles, the use of prophylaxis with systemic antibiotics in selected specialty procedures was examined. The operations reviewed were aortofemoral bypass, pulmonary resections, open-hip procedures, and head-neck cancer procedures that involve the oropharyngeal cavity. Of all patients, 74% received antibiotics preoperatively and 79% received prophylaxis with antibiotics longer than 24 hours postoperatively. Evaluated against the criteria of preoperative initiation and limited postoperative administration (less than 24 hours) only 10% of the patients received appropriate prophylaxis. A 3% incidence of drug-associated complications was identified; each patient with complications had received antibiotics for a prolonged time postoperatively. Reduction in the length of postoperative prophylaxis with systemic antibiotics will reduce (1) the number of drug-associated complications, (2) selection pressures on the hospital microbial population, and (3) needless expense in hospitalized patients.
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004363:Drug Utilization / Q000191:economics*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011182:Postoperative Care; D011300:Preoperative Care; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014656:Vascular Surgical Procedures
chemical_list: D000900:Anti-Bacterial Agents