Abstract
A controlled intervention study was to promote rational antibiotic prophylaxis in clean surgeries in Chinese tertiary hospitals from 2008 to 2009. The effect of the intervention was measured and compared before and after intervention (intervention group, IG, including twelve hospitals), and compared with the control group (CG, including 164 tertiary hospitals distributed in 31 provinces). There were a total of 3961 and 657 cases identified in IG & CG for the study. Comparing the changes of IG with CG following the 3rd intervention, the proportion of antibiotics use without indication decreased from 61.9% (IG) & 84.4% (CG) (χ2 test, P χ2 test, P > 0.05); the rationality scores increased from 55.4 (IG) & 57.6 (CG) (t test, P > 0.05) to 77.0 (IG) & 64.3 (CG) (t test, P
Highlights
The use of antibiotic prophylaxis is an accepted and widely practiced feature in modern surgeries
The results showed that the main problems of irrational antibiotic prophylaxis included antibiotic selection, medication given at wrong time, and the long duration of medication, accounting for 28.1%, 34% and 69.6% of the total indicated cases respectively
There were a total of 3,961 cases enrolled in the intervention group (IG) in the whole course of all interventions, and 657 cases analyzed in the control group (CG)
Summary
The use of antibiotic prophylaxis is an accepted and widely practiced feature in modern surgeries. The prevention and control of infection is a priority in healthcare, and the emergence of antibiotic resistance is a worldwide phenomenon. Though a lowered incidence of SSI with the use of prophylactic antibiotics is well documented, the inappropriateness of antibiotic prophylaxis has been extensively demonstrated in many situations. Antibiotics are often used in wrong doses, for too long, or with too broad a spectrum of antimicrobial activity [1,2,3,4]. Antimicrobial resistance, superinfection and unnecessary costs are common consequences of inappropriate surgical antibiotic prophylaxis [2,5].
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