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Antibiotic Prophylaxis in Cholecystectomies in a Teaching Hospital in Brazil

Pharmacist, Porto Alegre, Brazil

Isabela Heineck, PhD

Professor, Pharmacy School, Federal University of Rio Grande do Sul, Porto Alegre

Maria B Ferreira, PhD

Professor, Department of Pharmacology, ICBS, Federal University of Rio Grande do Sul

Reprints: Dr. Heineck, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga, 2752, Porto Alegre, 90610-000, Brasil, fax 051 3316 5281, isabelah{at}farmacia.ufrgs.br

BACKGROUND: Medical literature reports that adequate prophylaxis with antibiotics can reduce the incidence of postoperative infections.

OBJECTIVE: To investigate the impact of adopting multiple practices for improving the rational use of antibiotic prophylaxis in patients undergoing cholecystectomy and evaluate, during 2 periods, compliance with the hospital Drug Committee's recommendation and guidelines published in the medical literature.

METHODS: Data were collected from patients' medical records at the Hospital de Clínicas de Porto Alegre (HCPA), Brazil, in 2003. We evaluated 222 procedures as set by guidelines published in the literature and the hospital's recommendation.

RESULTS: In 24.5% of the cases, the choice of whether to use the prophylactic antibiotic was not made according to the guidelines. The choice of the antibiotic agent, prophylaxis duration, dose administered, and time for administration was appropriate in 95%, 80.5%, 100%, and 81.8% of cases, respectively. A significant improvement in guideline compliance was observed since multiple practices were adopted to improve the rational use of antibiotic prophylaxis.

CONCLUSIONS: Compliance with the guidelines for antibiotic prophylaxis for cholecystectomy, in combination with a greater integration among the professionals involved in the HCPA Infection Control Service, resulted in a more appropriate use of these prophylactic agents. Improving physicians' awareness of the importance of meeting guidelines is critical and will benefit patients and the hospital as a whole.

Key Words: antibiotic prophylaxis, cholecystectomy, guidelines, infection

Published Online, October 17, 2006. www.theannals.com, DOI 10.1345/aph.1H165