[Prophylactic antibiotic use in gastro-intestinal surgery: an audit of current practice].
OBJECTIVE
To evaluate compliance with clinical guidelines on prophylactic antibiotic usage in gastro-intestinal surgery.


METHODS
The medical charts of one hundred consecutive patients undergoing surgery in the last 6 months of 2006 were analysed as to determine whether the use of prophylactic antibiotics was indicated. Compliance with the prophylactic antibiotic guidelines of the Toulouse teaching hospitals and the Société Française d'Anesthésie et de Réanimation (SFAR) was examined; cases were analyzed by the criteria of the Haute Autorité en Santé for indication, type of antibiotic, time of administration, and duration of treatment.


RESULTS
Antibiotic prophylaxis was prescribed in 58% of patients; there was an 85% compliance rate with the indication. Of those receiving antibiotic prophylaxis, the choice of antibiotic was appropriate in 82.8%, but the timing of administration was in compliance in only 39.7%. Duration of antibiotic administration was excessive in 5 cases. The overall rate of compliance with guidelines was 42%.


CONCLUSIONS
Prophylactic antibiotic guidelines were inadequately applied, especially regarding the timing of administration. Further systemic progress is needed to achieve compliance with guidelines and documentation of administration; such evaluations must be repeated on regular basis.
Malavaud
S
S
Service d'épidémiologie, unité d'hygiène, CHU Rangueil - Toulouse. malavaud.s@chu-toulouse.fr
Bonnet
E
E
Vigouroux
D
D
Mounet
J
J
Suc
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000592:standards; D002985:Clinical Protocols; D003625:Data Collection; D013505:Digestive System Surgical Procedures; D005260:Female; D005602:France; D013502:General Surgery; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D013997:Time Factors
D000900:Anti-Bacterial Agents