Successful control program to implement the appropriate antibiotic prophylaxis for Cesarean section.
OBJECTIVE
Describe implementation of a successful program to reduce doses (cefazolin 2 to 1 g) used for antimicrobial prophylaxis.


METHODS
Evaluation of an intervention program to reduce prophylactic antimicrobial doses. The intervention included weekly staff discussions, automatic dispensation of 1g-vial of cefazolin by the pharmacy unless expressly requested by surgeon and increase in post-discharge surveillance as a strategy to reassure surgeons of the safety of the reduction. In the pre and post intervention periods, a prospective study of antimicrobial consumption and surgical site infections were measured.


RESULTS
There were 5,164 and 5,204 deliveries in 2001-2002 and 2003-2004, respectively; 1,524 (29.5%) and 1,363 (26%) were cesarean sections. There was a 45% decrease in cefazolin vials used on average per cesarean section (2.29 to 1.25). Patients evaluated increased from 16% to 67% and the SSI rates in both periods were 3.34% to 2.42%, respectively.


CONCLUSIONS
An ample intervention, including administrative and educational measures, led to high compliance with dose reduction and saved more than US$4,000 in cefazolin, considered important because government reimbursement in Brazil for cesarean section is $80.
Fonseca
Silvia Nunes Szente
SN
Department of Infection Control, Ribeirão Preto, SP, Brazil.
Sofia
Maria Helena
MH
Quintana
Silvana
S
Nogueira
Fernanda dos Santos
Fdos S
Levin
Anna S
AS
D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics; D019072:Antibiotic Prophylaxis / Q000191:economics / Q000379:methods*; D002437:Cefazolin / Q000008:administration & dosage* / Q000191:economics; D002585:Cesarean Section / Q000191:economics; D005260:Female; D006801:Humans; D011247:Pregnancy; D015397:Program Evaluation; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000191:economics / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D002437:Cefazolin