title: Current application of selective decontamination of the digestive tract, perioperative antibiotics and mechanical bowel preparation in surgical departments in the Netherlands.
abstract: OBJECTIVE
  To study the current application of selective decontamination of the digestive tract (SDD), the use of preoperative antibiotics and mechanical bowel preparation (MBP) in elective gastrointestinal (GI) surgery in surgical departments in the Netherlands.
  
  
  METHODS
  A point prevalence survey was carried out and an online questionnaire was sent to GI surgeons of 86 different hospitals.
  
  
  RESULTS
  The response rate was 74%. Only 4/64 (6.3%) of the Dutch surgical wards are currently using perioperative SDD as a prophylactic strategy to prevent postoperative infectious complications. The 4 hospitals using SDD on their surgical wards also use it on their ICUs. All hospitals make use of perioperative intravenous antibiotic prophylaxis in elective GI surgery. In most hospitals, a cephalosporin and metronidazole are applied (81.3 and 76.6%). MBP was used in 58 hospitals (90.6%) mainly in left colonic surgery.
  
  
  CONCLUSIONS
  Perioperative SDD is rarely used in elective GI surgery in the Netherlands. Perioperative intravenous antibiotic prophylaxis is given in all Dutch hospitals, conforming to guidelines. Although the recent literature does not recommend MBP before surgery, it is still selectively used in 90.6% of the Dutch surgical departments, mainly in open or laparoscopic left colonic surgery (including sigmoid resections).
authors: Department of Surgery, Flevoziekenhuis, Almere, The Netherlands. s.mutsaers@hotmail.com
authors: S N
authors: SN
authors: Mutsaers
authors: D
authors: D
authors: Roos
authors: H M
authors: HM
authors: Oudemans-van Straaten
authors: L T
authors: LT
authors: de Wit
authors: D J
authors: DJ
authors: Gouma
authors: M F
authors: MF
authors: Gerhards
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D002400:Cathartics / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use*; D003422:Critical Care; D003666:Decontamination; D041981:Gastrointestinal Tract / Q000601:surgery*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D008795:Metronidazole / Q000627:therapeutic use*; D009426:Netherlands; D011300:Preoperative Care; D013530:Surgical Wound Infection / Q000517:prevention & control*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002400:Cathartics; D002511:Cephalosporins; D054368:Laxatives; D008795:Metronidazole