title: Perioperative antibiotic prophylaxis and cost in a Turkish University Hospital.
abstract: Although surgical site infections have decreased with the use of prophylactic antibiotics, inappropriate surgical antibiotic prophylaxis is still a world-wide problem. In this retrospective study, perioperative antibiotic prophylaxis was evaluated in a university hospital. All surgical procedures (total 2038) performed in the year 2002 were included. The study setting was the Anesthesiology and Reanimation unit in Pamukkale University Medicine Faculty Hospital. A total of 1902 patients received antibiotic prophylaxis. Ninety-two percent of all procedures were elective, 8% emergencies. Approximately 85.7% were clean surgery, 8.5% clean-contaminated, 5.3% contaminated, and 0.5% dirty. Approximately 93.3% of patients received antibiotic prophylaxis. Although timing of prophylaxis was appropriate in all procedures, duration was optimal in only 29.0% of all cases. Sulbactam/ampicillin (33.2%), cefepime (23.4%), ceftriaxone (15.1%), ciprofloxacin (12.6%) and cefazolin (11%) were the most commonly used antibiotics. Instead of an estimated optimal cost of perioperative antibiotic prophylaxis ranging between US$2.6 and 7.8 according to guidelines, the average cost was US$62 per patient. We believe that compliance regarding the optimal choice, frequency and duration of perioperative antibiotic prophylaxis is inadequate, thereby making additional efforts necessary.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Akdeniz University, Medicine Faculty, Antalya. Turkey.
authors.forename: Ata Nevzat
authors.initials: AN
authors.lastname: Yalcin
authors.forename: Riza Hakan
authors.initials: RH
authors.lastname: Erbay
authors.forename: Simay
authors.initials: S
authors.lastname: Serin
authors.forename: Habip
authors.initials: H
authors.lastname: Atalay
authors.forename: Ozlem
authors.initials: O
authors.lastname: Oner
authors.forename: Arzu Didem
authors.initials: AD
authors.lastname: Yalcin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis / Q000191:economics / Q000706:statistics & numerical data*; D001424:Bacterial Infections / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004630:Emergencies; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D014421:Turkey / Q000453:epidemiology