title: Adherence to guidelines for antibiotic prophylaxis in general surgery: a critical appraisal.
abstract: OBJECTIVE
  To evaluate the adherence of general surgeons to guidelines for antimicrobial prophylaxis. This study was held from January 2000 until October 2000 in a General Surgery Clinic in a hospital in Athens, Greece.
  
  
  METHODS
  Eight hundred and ninety-eight patients were enrolled and operated on electively. Questionnaires concerning demographic data, health status, type of surgery (clean and clean-contaminated) and parameters of antibiotic prophylaxis (antibiotic choice, route, dose, timing of first dose, timing of operative redosing and duration of prophylaxis) were completed.
  
  
  RESULTS
  Of the patients, 44.8% underwent a clean surgical operation and 55.2% underwent a clean-contaminated surgical operation. Inguinal hernia repair and laparoscopic cholecystectomy were the commonest operations in each category. Second-generation cephalosporins were the most frequently prescribed antibiotics, in 67%. Although, only 78.5% of procedures required prophylaxis, it was administered in 97.5%, so it was not justified and inappropriately administered in 19%. It was revealed that 100% of patients received antibiotic prophylaxis on time. The choice of antimicrobial agent was appropriate in 70% and the duration of prophylaxis was optimal in 36.3%. The overall compliance rate of surgeons with guidelines for antibiotic prophylaxis was 36.3%.
  
  
  CONCLUSIONS
  Adherence to separate aspects of guidelines for surgical prophylaxis has to be improved. The duration of antibiotic prophylaxis was the main parameter of interest. Interventions have to be made about the development, distribution and adoption of adequate guidelines in collaboration with surgeons.
authors.affiliation: Department of Pharmacology, Medical School, University of Athens, Athens, Greece. chtourmou@med.uoa.gr
authors.forename: C E
authors.initials: CE
authors.lastname: Tourmousoglou
authors.forename: E Ch
authors.initials: ECh
authors.lastname: Yiannakopoulou
authors.forename: V
authors.initials: V
authors.lastname: Kalapothaki
authors.forename: J
authors.initials: J
authors.lastname: Bramis
authors.forename: J
authors.initials: J
authors.lastname: St Papadopoulos
mesh_terms: D019072:Antibiotic Prophylaxis; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D006115:Greece; D019983:Guideline Adherence; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D013503:Surgery Department, Hospital; D013514:Surgical Procedures, Operative
chemical_list: D002511:Cephalosporins