| Sub-title | |
| Authors | M A Borg P Zarb |
| Abstract | Introduction: Antibiotic prophylaxis aims to reduce the risk of postoperative infection when potential bacterial contamination of tissues occurs during surgery. It contributes to a substantial proportion of antibiotic usage in hospitals. The availability of evidence-based literature and policies offers a scope for auditing local practices to assess non-compliance and plan measures for intervention and improvement. Objective: To evaluate antimicrobial prophylaxis practices in surgery within St. Luke's Hospital, a 900-bed tertiary care facility in Malta, concentrating particularly on drug choice, timing and duration. Design: The study was undertaken through a retrospective assessment of patient records. A total of 287 cases of elective surgical procedures were assessed in the departments of general surgery, urology, orthopaedics and obstetrics & gynaecology.Main outcome measures: The data collected was evaluated and compared with local policies and recommendations in evidence based literature. Results: The results showed that the timing of antibiotic administration was according to recommended guidelines in 48% of cases. The choice of drug showed compliance in 45% of operations and was at least of the same antimicrobial class in another 16%. The most divergent results were found in the duration of prophylaxis where 78% of cases were given prophylactic antimicrobials for more than the recommended maximum of 24 hours. Conclusion: There is clearly a need for better educational interventions within the surgical establishment of the hospital to improve practices. Since the administration of prophylactic antibiotic is related to the time of induction of anaesthesia, it may be appropriate to assign this intervention as a responsibility of the anaesthetist, to be undertaken in consultation with the surgeon using published local guidelines as reference. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
| Pages | - |
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| Key words | prophylaxis, surgery, timing, anaesthesia induction |