Audit of antibiotic prophylaxis for surgical patients in three hospital trusts in Tayside. Tayside Area Clinical Audit Commitee.
OBJECTIVE
To compare achievement of previously agreed standards for administration of antibiotic prophylaxis for surgical patients in the three acute trusts in Tayside.


METHODS
Angus, Dundee Teaching Hospitals and Perth & Kinross Trusts.


METHODS
Administration of antibiotic prophylaxis and achievement of three general standards of administration.


METHODS
Prospective case note audit.


RESULTS
In total, 341 operations were audited. The range of operations performed in each trust was different and the achievement of standards was sensitive to case mix. For example, prophylaxis was given to 82% of all eligible orthopaedic patients but only 64% of eligible patients in obstetrics & gynaecology. Comparison between trusts was therefore confined to six procedures (166 operations) which were performed regularly in all three. There were significant differences between trusts in the rate of administration to patients undergoing operations for which prophylaxis was indicated (from 84% [95% CI 75-92] to 93% [CI 89-98]) and in the proportion of patients in whom prophylaxis was continued for less than 24 hours (from 78% [CI 68-89] to 97% [CI 93-100]). Administration of prophylaxis within two hours of surgery was achieved following more than 95% of operations in all three trusts. However, second doses were given to only five of 44 (11%) of patients whose operations lasted more than two hours.


CONCLUSIONS
Achievement of standards in all three trusts was good in comparison with recently published audits from other UK and European centres but there was still room for improvement, particularly in administration of second doses for prolonged operations. Regular audit of prophylaxis administration and duration should be implemented. Comparisons between trusts or units should be based on a common set of operations.
Davey
P
P
University of Dundee, Medicines Monitoring Unit, Department of Clinical Pharmacology, Ninewells Hospital, Dundee DD19SY.
Napier
A
A
McMillan
J
J
Ruta
D
D
D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D017723:Drug Utilization Review; D006779:Hospitals, Public / Q000592:standards; D006784:Hospitals, Teaching / Q000592:standards; D006801:Humans; D008485:Medical Audit; D009873:Operating Rooms / Q000592:standards*; D011300:Preoperative Care / Q000592:standards*; D012606:Scotland; D013530:Surgical Wound Infection / Q000517:prevention & control*