A national survey of surgical antibiotic prophylaxis in Turkey.
OBJECTIVE
To assess the quality of antibiotic prophylaxis for clean and clean-contaminated elective surgical procedures.


METHODS
A cross-sectional, country-wide survey.


METHODS
Thirty-six hospitals in 12 cities in Turkey.


METHODS
Four hundred thirty-nine surgeons from 6 different specialties who performed selected procedures of interest.


METHODS
A random sample of surgeons from different hospitals was selected. A standardized data collection form was used to record the type of procedure, the names, doses, timing of the first doses, and duration of antibiotics, important decisive factors, and problems in the management of prophylactic antibiotic use for surgical procedures.


RESULTS
Fifty-five percent of surgeons addressed completed the survey. For clean-contaminated procedures, 6% of surgeons did not use antibiotic prophylaxis, whereas 88% used more than a single dose. Inappropriate antibiotics were chosen for 32% of procedures. In 39% of procedures, the first dose of antibiotics was not administered during induction of anesthesia. Duration of prophylaxis was longer than 24 hours in 80% and longer than 48 hours in 46% of all procedures. Only 112 surgeons (26%) were using definitely appropriate prophylaxis in all ways. Multivariate analysis revealed that surgeons in university hospitals (OR, 2.353; CI95, 1.426-3.884; P = .001) and general surgeons (OR, 4.986; CI95, 2.890-8.604; P < .001) used antibiotic prophylaxis more appropriately. Patients not covered by health insurance (OR, 0.417; CI95 0.225-0.772; P < .001) were associated with inappropriate prophylaxis.


CONCLUSIONS
Given the high frequency of antibiotics prescribed for surgical prophylaxis in Turkey, adherence to surgical prophylaxis guidelines is urgently needed.
Hosoglu
Salih
S
Dicle University Hospital, Diyarbakir, Turkey.
Sunbul
Mustafa
M
Erol
Serpil
S
Altindis
Mustafa
M
Caylan
Rahmet
R
Demirdag
Kutbettin
K
Ucmak
Hasan
H
Mendes
Hawa
H
Geyik
Mehmet Faruk
MF
Turgut
Huseyin
H
Gundes
Sibel
S
Doyuk
Elif Kartal
EK
Aldemir
Mustafa
M
Dokucu
Ali ihsan
Ai
D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006761:Hospitals; D006801:Humans; D017053:Infection Control; D013043:Specialties, Surgical / Q000145:classification; D013514:Surgical Procedures, Operative / Q000145:classification; D013530:Surgical Wound Infection / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014421:Turkey