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A National Survey of Surgical Antibiotic Prophylaxis in Turkey

Published online by Cambridge University Press:  02 January 2015

Salih Hosoglu
Affiliation:
Dicle University Hospital, Diyarbakir, Turkey
Mustafa Sunbul
Affiliation:
Ondokuz Mayis University Hospital, Samsun, Turkey
Serpil Erol
Affiliation:
Ataturk University Hospital, Erzurum, Turkey
Mustafa Altindis
Affiliation:
Kocatepe University Hospital, Afyon, Turkey
Rahmet Caylan
Affiliation:
Farabi Hospital, Trabzon, Turkey
Kutbettin Demirdag
Affiliation:
Firat University Hospital, Elazig, Turkey
Hasan Ucmak
Affiliation:
Dicle University Hospital, Diyarbakir, Turkey
Havva Mendes
Affiliation:
Dicle University Hospital, Diyarbakir, Turkey
Mehmet Faruk Geyik
Affiliation:
Dicle University Hospital, Diyarbakir, Turkey
Huseyin Turgut
Affiliation:
Pamukkale University Hospital, Denizli, Turkey
Sibel Gundes
Affiliation:
Kocaeli University Hospital, Kocaeli, Turkey
Elif Kartal Doyuk
Affiliation:
Osman Gazi University Hospital, Eskisehir, Turkey
Mustafa Aldemir
Affiliation:
Dicle University Hospital, Diyarbakir, Turkey
Ali ihsan Dokucu
Affiliation:
Dicle University Hospital, Diyarbakir, Turkey

Abstract

Objective:

To assess the quality of antibiotic prophylaxis for clean and clean-contaminated elective surgical procedures.

Design:

A cross-sectional, country-wide survey.

Setting:

Thirty-six hospitals in 12 cities in Turkey.

Participants:

Four hundred thirty-nine surgeons from 6 different specialties who performed selected procedures of interest.

Methods:

A random sample of surgeons from different hospitals was selected. A standardized data collection form was used to record the type of procedure, the names, doses, timing of the first doses, and duration of antibiotics, important decisive factors, and problems in the management of prophylactic antibiotic use for surgical procedures.

Results:

Fifty-five percent of surgeons addressed completed the survey. For clean-contaminated procedures, 6% of surgeons did not use antibiotic prophylaxis, whereas 88% used more than a single dose. Inappropriate antibiotics were chosen for 32% of procedures. In 39% of procedures, the first dose of antibiotics was not administered during induction of anesthesia. Duration of prophylaxis was longer than 24 hours in 80% and longer than 48 hours in 46% of all procedures. Only 112 surgeons (26%) were using definitely appropriate prophylaxis in all ways. Multivariate analysis revealed that surgeons in university hospitals (OR, 2.353; CI95, 1.426–3.884; P = .001) and general surgeons (OR, 4.986; CI95, 2.890–8.604; P < .001) used antibiotic prophylaxis more appropriately. Patients not covered by health insurance (OR, 0.417; CI95, 0.225–0.772; P < .001) were associated with inappropriate prophylaxis.

Conclusion:

Given the high frequency of antibiotics prescribed for surgical prophylaxis in Turkey, adherence to surgical prophylaxis guidelines is urgently needed.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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