Evaluation of clinical practice: Audit of prophylactic antibiotics in urology

Objective. - To evaluate compliance with clinical practice guidelines concerning prophylactic antibiotics in urologicat surgery. Material and methods. - Thirty per cent of the medical charts for the first 288 patients operated in 2005 and requiring prophylactic antibiotics were selected at random. On this sample of 84 patients, compliance with the CHU de Toulouse (Toulouse teaching hospital) and soci6t6 francaise d'anesth6sie et de r6animation (SFAR) (French Society of Anaesthesia and Intensive Care), prophylactic antibiotic guidelines were investigated according to the method recommended by the Centre de coordination de da tutte dontre des infections nosocomiates (CCLIN) Ouest (Nosocomiat Infection Control Coordination Centre) which analyses the indication, type of antibiotic, time of administration and duration of treatment. Results. - The compliance rate with the indication was 88.1%. When prophylactic antibiotics were effectively administered, compliance with guidelines were 91.9% for type of antibiotic and 72.9% for time of administration. The duration was excessive in one case. The overall compliance rate was 58.3%. Conclusion. - Prophylactic antibiotic guidelines were inadequately applied, especially concerning the time of administration. Further progress must be made in terms of compliance with guidelines and recording of administration, which must be repeatedly evaluated. (c) 2008 Elsevier Masson SAS. Tous droits reserves.