[Adequacy assessment of antibiotic prophylaxis in orthopedic and traumatologic surgery].
BACKGROUND
Antibiotic prophylaxis is an essential strategy for preventing surgical wound infection. This study assesses the adequacy of surgical antibiotic prophylaxis in trauma and orthopedic patients.


METHODS
Cross-sectional study including consecutive patients who underwent hip or knee replacement, or spinal surgery. Sample estimation was based on 95% confidence, 5% precision, an overall adequacy of 85%, and assuming a loss of 5%. Thus, 206 patients were required. The appropriateness of the indication, time of administration, administration route, and dose according to the hospital protocol was assessed. The cumulative incidence of surgical site infection at discharge was determined.


RESULTS
A total of 221 patients were included, 33.5% men and 66.5% women; mean age was 61.1 (SD=14.1) for men and 67.1 (SD=12.4) for woman (P<0.05). Antibiotic prophylaxis was indicated in all patients. Overall adequacy of prophylaxis according to the hospital protocol was 89.1%. Cumulative incidence of surgical wound infection at discharge was 3.2%. There was no association between the adequacy of antibiotic prophylaxis and surgical site infection (P>0.05).


CONCLUSIONS
The adequacy of postoperative antibiotic prophylaxis was high in this study, but it can be improved.
Rodríguez-Caravaca
Gil
G
Unidad de Medicina Preventiva, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España. grodriguez@fhalcorcon.es
Santana-Ramírez
Samuel
S
Villar-Del-Campo
Maria Concepción
MC
Martín-López
Rocío
R
Martínez-Martín
Javier
J
Gil-de-Miguel
Angel
A
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control*; D002985:Clinical Protocols; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007796:Laminectomy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013123:Spinal Fusion / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D014947:Wounds and Injuries / Q000150:complications / Q000601:surgery*
D000900:Anti-Bacterial Agents