title: An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study.
abstract: OBJECTIVE
  The purpose of this study was to evaluate compliance with guidelines in surgical prophylaxis (SP) procedures in Turkey.
  
  
  METHODS
  A point prevalence study involving 4 university, 5 education and research and 7 public hospitals was performed assessing compliance with guidelines for antibiotic use in SP. Compliance was based on the "Clinical Practice Guidelines for Antimicrobial Surgery (CPGAS) 2013" guideline.
  
  
  RESULTS
  Sixteen centers were included in the study, with 166 operations performed at these being evaluated. Parenteral antibiotic for SP was applied in 161 (96.9%) of these. Type of antibiotic was inappropriate in 66 (40.9%) cases and duration of use in 47 (29.1%). The main antibiotics used inappropriately in SP were ceftriaxone, glycopeptides and aminoglycosides. No significant difference was observed between secondary and tertiary hospitals in terms of inappropriate selection. Duration of prophylaxis was also incompatible with guideline recommendations in approximately half of surgical procedures performed in both secondary and tertiary hospitals, however statistical significance was observed between institutions in favor of tertiary hospitals.
  
  
  CONCLUSIONS
  Antibiotics are to a considerable extent used in a manner incompatible with guidelines even in tertiary hospitals in Turkey. It must not be forgotten that several pre-, intra- and postoperative factors can be involved in the development of surgical site infections (SSI), and antibiotics are not the only option available for preventing these. A significant improvement can be achieved in prophylaxis with close observation, educational activities, collaboration with the surgical team and increasing compliance with guidelines. All health institutions must establish and apply their own SP consensus accompanied by the guidelines in order to achieve success in SP.
authors.affiliation: Department of Infectious Diseases and Microbiology, Karadeniz Technical University School of Medicine, Trabzon; Hospital Infections Prevention and Control Committee, Karadeniz Technical University School of Medicine, Trabzon, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Kaya
authors.affiliation: Hospital Infections Prevention and Control Committee, Karadeniz Technical University School of Medicine, Trabzon, Turkey.
authors.forename: Seyhan
authors.initials: S
authors.lastname: Aktas
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey.
authors.forename: Seniha
authors.initials: S
authors.lastname: Senbayrak
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine Diyarbakır, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Tekin
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Nefise
authors.initials: N
authors.lastname: Oztoprak
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Kanuni Training and Research Hospital, Trabzon, Turkey.
authors.forename: Firdevs
authors.initials: F
authors.lastname: Aksoy
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Firat
authors.affiliation: Infection Control Committee, Zonguldak Obstetrics and Pediatric Diseases Hospital, Zonguldak, Turkey.
authors.forename: Sevinc
authors.initials: S
authors.lastname: Yenice
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Şişli Etfal Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ahsen
authors.initials: A
authors.lastname: Oncul
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Şişli Etfal Training and Research Hospital, İstanbul, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Gunduz
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Yıldırım Beyazıt University, Yenimahalle Training and Research Hospital, Ankara, Turkey.
authors.forename: Semiha
authors.initials: S
authors.lastname: Solak
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ayten
authors.initials: A
authors.lastname: Kadanali
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Sule Eren
authors.initials: SE
authors.lastname: Cakar
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, İzmir M. Enver Şenerdem Torbalı Public Hospital, İzmir, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Caglayan
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey.
authors.forename: Hava
authors.initials: H
authors.lastname: Yilmaz
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey.
authors.forename: Ilkay
authors.initials: I
authors.lastname: Bozkurt
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Ardahan State Hospital, Ardahan, Turkey.
authors.forename: Tulin
authors.initials: T
authors.lastname: Elmaslar
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Cizre State Hospital, Cizre, Turkey.
authors.forename: Ayse Sagmak
authors.initials: AS
authors.lastname: Tartar
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, İzmir Kemalpaşa Public Hospital, İzmir, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Aynioglu
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Zonguldak Atatürk Public Hospital, Zonguldak, Turkey.
authors.forename: Nilgun Fidan
authors.initials: NF
authors.lastname: Kocyigit
authors.affiliation: Department of Infectious Diseases and Microbiology, Karadeniz Technical University School of Medicine, Trabzon; Hospital Infections Prevention and Control Committee, Karadeniz Technical University School of Medicine, Trabzon, Turkey.
authors.forename: Iftihar
authors.initials: I
authors.lastname: Koksal
keywords: Surgical prophylaxis; Turkey; antibiotics