title: Surgical antibiotic prophylaxis compliance in a university hospital.
abstract: OBJECTIVE
  To assess surgical antibiotic prophylaxis (SAP) practices in a university hospital in order to identify risk factors associated with non-compliance.
  
  
  METHODS
  Retrospective monocentric study conducted over a 4-month period.
  
  
  METHODS
  Data were collected from the software used in the operating theatre. Practice non-compliance was evaluated in comparison with the 2010 version of the French national recommendations. We only took in account the interventions identified as priority surveillance interventions according to the surgical site infections national surveillance. The risk factors associated with SAP non-compliance were identified with a multivariate statistical analysis.
  
  
  RESULTS
  We evaluated 1312 SAPs. Among the 1298 indicated SAPs, 44.4% were not compliant. The most frequent inappropriate criterion was the timing of injection (34.8% non-compliance), which was, in the majority of cases, too close to the time of incision. Other inappropriate criteria were identified: antibiotic choice for patients allergic to β-lactams (inappropriate among 45% of allergic patients), and antibiotic dosing for obese patients (96% of non-compliance). Obesity (OR=84.32), allergy to β-lactams (OR=17.11) and certain types of surgery (digestive, OR=4.56; gynaecological and obstetrical, OR=7.10; urological, OR=3.95) were independently associated with the non-compliance of SAP practices.
  
  
  CONCLUSIONS
  Improvement measures that target the timing of injection, obese or allergic patients are necessary.
authors.affiliation: UMR 6249 chrono-environnement, service d'hygiène hospitalière, centre hospitalier régional universitaire, 3, boulevard Fleming, 25000 Besançon, France. Electronic address: a3muller@chu-besancon.fr.
authors.forename: Allison
authors.initials: A
authors.lastname: Muller
authors.affiliation: UMR 6249 chrono-environnement, service des maladies infectieuses, centre hospitalier régional universitaire, 3, boulevard Fleming, 25000 Besançon, France.
authors.forename: Joel
authors.initials: J
authors.lastname: Leroy
authors.affiliation: Pharmacie centrale, centre hospitalier régional universitaire, 3, boulevard Fleming, 25000 Besançon, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Hénon
authors.affiliation: Service de bactériologie, centre hospitalier régional universitaire, 3, boulevard Fleming, 25000 Besançon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Patry
authors.affiliation: Pôle d'anesthésie-réanimation chirurgicale, centre hospitalier régional universitaire, 3, boulevard Fleming, 25000 Besançon, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Samain
authors.affiliation: UMR 6249 chrono-environnement, service des maladies infectieuses, centre hospitalier régional universitaire, 3, boulevard Fleming, 25000 Besançon, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Chirouze
authors.affiliation: UMR 6249 chrono-environnement, service d'hygiène hospitalière, centre hospitalier régional universitaire, 3, boulevard Fleming, 25000 Besançon, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bertrand
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D019072:Antibiotic Prophylaxis / Q000592:standards*; D005260:Female; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult; D047090:beta-Lactams / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams
keywords: Compliance; Evaluation of practices; Recommendations; Surgical antibiotic prophylaxis