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2016, Number 1

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Acta Med 2016; 14 (1)

Use of preoperative and postoperative antibiotics in the department of general surgery of a private hospital and a comparison with the current guidelines for antimicrobial management

Zubieta OG, González ACA, Cartagena SEJ, Peña VVI, Garzón MJ, Robledo OF
Full text How to cite this article

Language: Spanish
References: 11
Page: 12-18
PDF size: 140.63 Kb.


Key words:

Antibiotics, preoperative prophylaxis, antibiotic guidelines, abdominal infections, antimicrobial management, postoperative management.

ABSTRACT

There is a wide variety of antibiotics that possess different action spectrum for each type of infection. Multiple factors should be considered before selecting the optimal type of antibiotic for each infectious process. Objective: To evaluate the use and adherence to prophylactic antibiotics and postoperative schemes proposed by various international guidelines and to propose an institutional guide based on each procedure. Methods: Review of records of 100 patients undergoing abdominal surgical procedures between September 1 and November 30, 2013, to assess adherence to prophylactic and postoperative antibiotics to different schemes proposed by international guidelines. Results: The three most common procedures were: cholecystectomy, fundoplication and appendectomy; representing 30, 18 and 17% respectively. Ceftriaxone was the most used postoperative and prophylactic antibiotic followed by levofloxacin. Cholecystectomy was the most common procedure with prophylactic antibiotic use, in 73.3% of the cases; 100% of exploratory laparotomies and colon surgery had a postoperative antimicrobial management. Conclusions: Making a contrast to the principles established in the consulted guides, the ignorance and arbitrary use of antibiotic agents is remarkable.


REFERENCES

  1. Hampson FG, Ridgway EJ. Prophylactic antibiotics in surgery. Surgery (Oxford). 2005; 23 (8): 290-293.

  2. Ng RS, Chong CP. Surgeons’ adherence to guidelines for surgical antimicrobial prophylaxis – a review. Australas Med J. 2012; 5 (10): 534-540.

  3. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999; 20 (4): 250-278.

  4. Hawn MT et al. Timing of surgical antibiotic prophylaxis and the risk of surgical site infection. JAMA Surg. 2013; 148 (7): 649-657.

  5. Sartelli M et al. Guías de la WSES del 2013 para el tratamiento de las infecciones intraabdominales. World Journal of Emergency Surgery. 2013; 8: 3.

  6. Daskalakis K et al. The use of pre- or postoperative antibiotics in surgery for appendicitis: a systematic review. Scand J Surg. 2013; 0: 1-7.

  7. Elbur AI et al. An audit of prophylactic surgical antibiotic use in a Sudanese Teaching Hospital. Int J Clin Pharm. 2013; 35: 149-153.

  8. Sartelli M et al. Antimicrobial management of intra-abdominal infections: Literature’s guidelines. World J Gastroenterol. 2012; 18 (9): 865-871.

  9. Solomkin JS et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the surgical infection society and the infectious diseases society of America. Clin Infect Dis. 2010; 50: 133-164.

  10. Gilbert D. The Sanford guide to antimicrobial therapy 2014. 44th ed. Sperryville, Va.: Antimicrobial Therapy. 2014.

  11. Antibiotic Guidelines 2013-2014 Johns Hopkins. The Johns Hopkins Hospital Antimicrobial Stewardship Program, 2014. Disponible in: hopkinsmedicine.org/amp




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Acta Med. 2016;14