[Prophylactic antibiotics in urological surgery: compliance of prescriptions in Franche-Comté with national guidelines].
OBJECTIVE
To evaluate prophylactic antibiotic practices in urological surgery in Franche-Comté.


METHODS
Six urological surgery teams participated in data collection. Practices were evaluated in comparison with national guidelines by means of five questions: Did the surgical operation justify prophylactic antibiotics and was this treatment administered? Was the antibiotic selected that recommended by national guidelines? Was the total duration appropriate? Was the time of the first injection appropriate? Was the dosage appropriate? The Société Française d'Anesthésie et de Réanimation (SFAR) guidelines, revised in 1999, constituted the reference.


RESULTS
Of the 213 operations included in the study, 134 corresponded to Altemeier class 1 and 2 operations for which the SFAR has issued guidelines. The overall compliance rate was 22.6%. Among the 56 patients who did not receive the recommended molecule, 45 received a molecule with a broader spectrum of activity than that of the recommended molecule. The duration of prophylactic antibiotics was longer for 10 of the 11 patients in whom the duration of prophylaxis did not comply with guidelines. Finally, for more than one third of operations, the time of injection of the first dose was not optimal.


CONCLUSIONS
This study demonstrated the high frequency of non-compliance with prophylactic antibiotic prescription guidelines in urological surgery in Franche-Comté. These guidelines must be reinforced and applied to ensure the efficacy of prophylactic antibiotics and to avoid the emergence of resistant strains.
Talon
Isabelle
I
Réseau Franc-Comtois de Lutte contre les Infections Nosocomiales, CHU Jean Minjoz, Besançon, France.
Lallemand-de Conto
Séverine
S
Talon
Daniel
D
D019072:Antibiotic Prophylaxis; D005260:Female; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013520:Urologic Surgical Procedures