[Evaluation of clinical practice: audit of prophylactic antibiotics in urology].
OBJECTIVE
To evaluate compliance with clinical practice guidelines concerning prophylactic antibiotics in urological surgery.


METHODS
Thirty per cent of the medical charts for the first 288 patients operated in 2005 and requiring prophylactic antibiotics were selected at random. On this sample of 84 patients, compliance with the CHU de Toulouse (Toulouse teaching hospital) and société française d'anesthésie et de réanimation (SFAR) (French Society of Anaesthesia and Intensive Care), prophylactic antibiotic guidelines were investigated according to the method recommended by the Centre de coordination de da lutte dontre des infections nosocomiales (CCLIN) Ouest (Nosocomial Infection Control Coordination Centre) which analyses the indication, type of antibiotic, time of administration and duration of treatment.


RESULTS
The compliance rate with the indication was 88.1%. When prophylactic antibiotics were effectively administered, compliance with guidelines were 91.9% for type of antibiotic and 72.9% for time of administration. The duration was excessive in one case. The overall compliance rate was 58.3%.


CONCLUSIONS
Prophylactic antibiotic guidelines were inadequately applied, especially concerning the time of administration. Further progress must be made in terms of compliance with guidelines and recording of administration, which must be repeatedly evaluated.
Unité d'hygiène, service d'épidémiologie, CHU de Toulouse-Rangueil, 1, avenue du Professeur-Jean-Poulhès, 31059 Toulouse cedex 9, France. malavaud.s@chu-toulouse.fr
S
S
Malavaud
E
E
Bonnet
F
F
Atallah
R
R
El Farsaoui
J
J
Roze
M
M
Mazerolles
P
P
Massip
P
P
Rischmann
P
P
Plante
B
B
Malavaud
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D003428:Cross Infection / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005602:France; D019983:Guideline Adherence; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D013997:Time Factors; D013520:Urologic Surgical Procedures / Q000592:standards*
D000900:Anti-Bacterial Agents