title: Audits of the quality of perioperative antibiotic prophylaxis in Shandong Province, China, 2006 to 2011.
abstract: BACKGROUND
  A prospective multicenter survey was conducted to assess the rational use of antibiotics in clean and clean-contaminated elective surgical procedures applied in 53 grade III first class hospitals in Shandong Province, China, from 2006 to 2011. The survey was designed to examine the prevalence of antibiotic prophylaxis, evaluate the quality of perioperative antibiotic prophylaxis (PAP) prescriptions, and investigate the risk factors associated with inappropriate indication for antibiotic prophylaxis.
  
  
  METHODS
  Medication charts and medical, anesthetic, and nursing records were reviewed. Antibiotic prescriptions were compared with the Chinese National Antibiotic Guideline on indication, antibiotic combination, antibiotic choice, dose, dosing interval, route of administration, timing of first administration, and duration of prophylaxis.
  
  
  RESULTS
  14,261 of 14,525 procedures (98.2%) receiving antibiotic prophylaxis. The most frequently encountered noncompliance types were PAP indications (18.6%), duration of prophylaxis (26.7%), and timing of first administration (30.3%). The steps of PAP were justified and correct only in 9.4% of procedures. Risk factors independently associated with inappropriate indication for antibiotic prophylaxis were seen in age, hospital type, hospital size, surgical disciplines, and surgical duration.
  
  
  CONCLUSIONS
  Results showed a significantly high rate of antibiotic prophylaxis in clean and clean-contaminated elective surgery and also a high prevalence of inappropriate indication prescriptions. These findings suggest important areas for intervention and implementation of antibiotic stewardship policies in Shandong Province hospitals.
authors.affiliation: Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Ou
authors.affiliation: Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Bai-qian
authors.initials: BQ
authors.lastname: Jing
authors.affiliation: Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Fang-fang
authors.initials: FF
authors.lastname: Guo
authors.affiliation: Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xie
authors.affiliation: Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Ying-li
authors.initials: YL
authors.lastname: Fang
authors.affiliation: Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Cui
authors.affiliation: Department of Respiratory Medicine, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xiao
authors.affiliation: Intensive Medical Care Unit, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Da-wei
authors.initials: DW
authors.lastname: Wu
authors.affiliation: Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, China. Electronic address: wenzhou25@126.com.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Clean surgery; Rational use