[Analysis of surgical antibiotic prophylaxis]

Saenz JR, Elguea E, Villate JI, Beguiristain A, Garcia-Arenzana JM, Iturburu I, Larrinaga JR, Escobar A, Martinez M, Aldamiz-Echeverria G, Rodriguez C, Lopez G
Record ID 32011000198
Original Title: Análisis de la Profilaxis Antibiótica Quirúrgica
Authors' objectives: 1-Determine the effectiveness of antibiotic prophylaxis procedures in surgery. 2- Determine the factors that affect the variability in their use. 3-Verify non desired effects. 4-Consider the cost of each procedure from an objective viewpoint. 5-Establish indications and standards for use.
Authors' results and conclusions: All the hospitals studied have a written protocol. All of these indicate single dosage and intravenous via (iv) as the means of administration. 80% of the hospitals have updated their protocol over recent years. 9.1% of the surgeons interviewed do not know of the existence of the protocol in their hospital centre. The single dosage is used in 73% of the services and in 12.7% this is used only occasionally. This is applied on inducing the anaesthesia in 56.4% of cases.
Authors' recommendations: The drug will be administered intravenously and on inducing the anaesthesia. 1- General Surgery Duodeno-Gastro-Esophageal surgery: - In LC and C surgery: Cefuroxima (cef 2nd gen)1.5 g or Amoxillinclavulanate 2g. - If there is a risk of infection by Pseudomonas aeruginosa: Piperacillin-Tazobactam 4.5 g iv. - Allergy to Β-lactamics: Gentamicine 160 mg + Clindamicine 600 mg iv. Hepatic-bile surgery: - Cefuroxime 1,5g iv o - Amoxillin-clavulanate 2 g iv. - Allergy to Β-lactamics: Gentamicine 160 mg + Clindamicine 600 mg iv. Colon-rectum surgery - Amoxillin-clavulanate 2 g. - Allergy to Β-lactamics: Gentamicina 160 mg + Clindamicine 600 mg.o Clindamicina + Metronidazol 1.5 g iv (more expensive). 2- Gynaecological surgery: - L and LC surgery: Amoxillin-clavulanate 2g. - Allergy to Β-lactamics: Gentamicine 160 mg + Clindamicine 600 mg. 3- Maxilla-facial - L with implants: Cefazoline (cef 1st gen) 2 g iv - Allergy to Β-lactamics: Clindamicine 600 mg - LC y C: Amoxillin-clavulanate 2 g iv. single dose with the induction of anesthesia. - Allergy to Β-lactamics: Gentamicine 160 mg + Clindamicine 600 mg 4- Traumatological Surgery - L with implants: Cefazoline (cef 1st gen) 2g - Allergy: Vancomicina 1 g 5- Otorhinolaryngological surgery - L with implants: Cefazoline 2 g - LC and C: Amoxillin-clavulanate 2 g - Risk of intercranial passage: Cefotaxime 2 g o Ceftriaxone 1 g - Allergy: Clindamicine 600 mg iv + Tobramicine 200 mg. 6- Plastic surgery - L with implants, LC y C: Cefazoline 2g . - Allergy: Clindamicine 600 mg. 7- Thoracic surgery - L: Cefuroxime (cef 3rd gen) 1,5 g - LC and C: Cefuroxime 1.5 g iv or Amoxillin-clavulanate 2 g. - Allergy: Gentamicine 160 mg+Clindamicine 600 mg . 8- Urological surgery - LC and C: Tobramicine 200 mg The patients studied do not require prolongation of antibiotic prophylaxis. 9- Vascular Surgery - Cefazoline 2g. - With implants and repeat operations: Cefazoline 2g +Gentamicine 160 mg. Allergy: Vancomicine 1g. 10- Neurosurgery - L, LC: Amoxillin-clavulanate 2 g - Contact with SNC: Cefotaxime 2 g iv or Ceftriaxone 1 g - Shunt or allergies: Vancomicine 1 g.
Authors' methods: The subjects studied are the surgical services of the Basque public health care network (Osakidetza). Design: the study will be carried out in the following stages: a. Review and subsequent evaluation of the literature, collecting any information available in different databases. b. Compilation and analysis of protocols. c. Personal survey made among specialists in the different surgical services. The research team is responsible for this entire process.
Project Status: Completed
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Surgical Wound Infection
  • Antibiotic Prophylaxis
  • Surgical Procedures
Organisation Name: Basque Office for Health Technology Assessment
Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz
Contact Name: Lorea Galnares-Cordero
Contact Email: lgalnares@bioef.eus
Copyright: <p>Basque Office for Health Technology Assessment (OSTEBA)</p>
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