The prophylactic uses of antibiotics for the prevention of surgical site infection and the effects: The 3-year experience in a tertiary hospital

Abstract Background : The objective of this study was to examine the effect of manag ement system for the appro-priate prophylactic use of antibiotics in surgical patients at a tertiary hospital from 2007 to 2010. Methods : We collected clinical data of three different surgical procedu res(colectomy, heart surgery, hysterectomy) for three months of 2007 and 2010, respectively. The number of total cases was 245(137, 54, 54) in 2007, 240(133, 42, 65) in 2010. We measured the rate of use of inappropriate prophylactic antibiotics, administration within 1 hour prior to the incision and the anti biotics prescription days after surgery. To evaluate the effectiveness of the management system, the result s of the two groups(Group1=2007, Group2=2010) were compared by t-test, chi-square test or Fisher ’s exact test. Result : The rate of Aminoglycoside uses decreased drastically from 11. 4% to 0.8%(P<.001). The selection of 3rd/4th Cephalosporin dropped from 11.8% to 5.8%(P=.020). Th e combination of antibiotics decreased from 27.8% to 11.7%(P<.001). The antibiotic prescription rate o n discharge declined from 11.8% to 2.5% (P<.001) and the number of antibiotics prescription days after surgery was shortened from 4.2 days to 2.3 days(P<.001). No significant difference in the rate of administ ration within 1 hour between two groups was found. Through 3-year management, 5 out of 6 measures were sign ificantly improved(except the admin-istration within 1 hour). The rate of surgical site infection d ecreased from 2.4% to 1.3%(P=.504).