Quality of surgical antibiotic prophylaxis using E-prescrption conditioning
© Rodrigues et al; licensee BioMed Central Ltd. 2011
Published: 29 June 2011
Introduction / objectives
Hospital da Luz is a paper-free hospital. Antibiotic prescription is made electronically and is automatically conditioned by both context and duration. We aimed to assess the pattern of use of antibiotics in surgical prophylaxis in a general hospital.
Prophylactic antibiotic prescriptions for patients undergoing surgery in January 2011 were extracted from the medical records. Variables collected included: surgical procedure, prophylactic antibiotic prescribed (ATC code), surgery classification (clean, clean contaminated, contaminated and dirty), and prophylaxis duration. A descriptive statistical analysis and cross-tabulations (chi-square) were performed.
611 prophylactic antibiotics were initiated for patients with an average age of 49.6 years (SD=16.6), (60.6% females). Surgeries were classified as: clean (39.1%), clean contaminated (29.4%), contaminated (2.1%) and dirty (1.2%). Most prescribed antibiotics were: first-generation cephalosporins (83.6%), second-generation cephalosporins (8.0%), imidazole derivatives (4.6%) and quinolones (1.8%). Antibiotic administration was exclusively intraoperative in 50.8% of the cases. 34.5% of the prescriptions were extended for 24 hours, 12.4% for 48 hours and 2.3% for more than 48 hours. Statistical association between surgery classification and treatment duration was found (chi-square p=0.010). Quinolones were prescribed only in urological surgery and imidazoles were prescribed only in colorectal surgery.
Antibiotic prophylaxis using e-prescription conditioning resulted on adequate compliance with guidelines, although opportunities for improvement were found.
Disclosure of interest
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.