[Audit of preoperative antibiotic prophylaxis in a surgical site infections surveillance network].
OBJECTIVE
To evaluate the preoperative antibiotic prophylaxis (PAP) prescriptions in a surgical site infection (SSI) surveillance network.


METHODS
Auto-evaluative audit in a prospective multicenter cohort included in a surveillance system.


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.


CONCLUSIONS
Efforts should be made to improve PAP prescription according to standards guidelines.
Rioux
C
C
Centre de coordination de la lutte contre les infections nosocomiales, 15-21, rue de l'Ecole-de-médecine, 75006 Paris, France. christophe_rioux@hotmail.com
Blanchon
T
T
Golliot
F
F
Berrouane
Y
Y
Chalfine
A
A
Costa
Y
Y
Laisné
M J
MJ
Levy
S
S
Richard
L
L
Seguier
J C
JC
Botherel
A H
AH
Astagneau
P
P
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000592:standards* / Q000706:statistics & numerical data; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000592:standards; D005602:France / Q000453:epidemiology; D017408:Guidelines as Topic; D006801:Humans; D008485:Medical Audit; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents