Antimicrobial prophylaxis for surgical procedures in Franche-Comte. Compliance with national referential system.

Aim of the study: To evaluate the practice of antibiotic prophylaxis for surgery in the Franche-Comte region of France. Materials and methods: A total of 36 surgical teams (72 pairs surgeons/anaesthesists) participated in data collection. Five variables describing practices concerning antibiotic prophylaxis for surgery were compared to national recommendations: did the surgical procedure require antibiotic prophylaxis and was it carried out? Was the antibiotic used appropriately? Was the timing of the first injection optimal? Was the total duration of the treatment correct? Was the dose correct? Results: Among the 687 operations for which data were collected, 513 (74.7%) that corresponded to class 1 or 2 Altemeier operations for which the Societe Francaise d'Anesthesie et Reanimation (SFAR) had drawn up recommendations were analysed in order to answer these questions. The overall frequency of conformity with the regulations was 40% for these 513 operations. Of the 156 patients who did not receive the recommended antibiotic, 133 (85.5%) received an antibiotic with an activity range wider than that of the recommended antibiotic. The duration of prophylaxis was longer than recommended in 80 (87.9%) out of the 91 patients for whom the duration of antibiotic prophylaxis did not respect the recommendations. Conclusions: This prospective surveillance showed that less than 50% of patients received an antibiotic prophylaxis that was conformed to the regulations. To ensure the efficiency of prophylaxis and to prevent deleterious effects, such as the emergence of antibiotic-resistant bacteria, the recommendations must be regularly respected. Frequent audits of practices should be carried out by the teams responsible for fighting nosocomial infections. (C) 2001 Editions scientifiques et medicales Elsevier SAS.