Surgical antibiotic prophylaxis in smaller hospitals.
BACKGROUND
In 2004, The Victorian Hospital Acquired Infection Surveillance System Coordinating Centre established a smaller hospital (<100 beds) surveillance programme that included an optional 'surgical antibiotic prophylaxis' (SAP) module. Appropriate SAP is believed to be one of the most effective strategies to reduce surgical site infections after certain surgical procedures.


METHODS
Trained infection control nurses in the participating hospitals were asked to collect SAP data for the first 50 consecutive procedures that could be classified into 1 of 12 surgical groups. The choice, timing and duration of antibiotics were compared against the Australian Therapeutic Antibiotic version 12 Guidelines and the US National Surgical Infection Prevention Project Advisory Statement.


RESULTS
Fifty-one of the 87 smaller hospitals that participated in the surveillance programme of The Victorian Hospital Acquired Infection Surveillance System Coordinating Centre carried out surgery. Over 20 months, 25 of these hospitals contributed data on 1872 procedures. Antibiotic choice, timing and duration were 52.6, 54.7 and 76.1%, respectively, concordant with published recommendations. For antibiotic choice in five surgical groups (appendectomy, colon surgery, gastric surgery and abdominal and vaginal hysterectomies), less than half of the procedures were concordant with the Australian Therapeutic Antibiotic Guidelines.


CONCLUSIONS
Substantial opportunities exist in smaller hospitals to improve compliance with published SAP recommendations. Further studies are required to determine the reasons for poor compliance with these recommendations.
Bennett
Noleen J
NJ
The Victorian Hospital Acquired Infection Surveillance System Coordinating Centre, Melbourne Health, Victoria, Australia. noleen.bennett@mh.org.au
Bull
Ann L
AL
Dunt
David R
DR
Russo
Philip L
PL
Spelman
Denis W
DW
Richards
Michael J
MJ
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D001315:Australia; D004334:Drug Administration Schedule; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006743:Hospital Bed Capacity, under 100; D006801:Humans; D017053:Infection Control / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data
D000900:Anti-Bacterial Agents