Abstract
Problem
The efficacy of perioperative antimicrobial therapy in reducing the rate of wound infections has been demonstrated in clinical trials. However, their use is not a panacea and their misuse may have considerable implications including the emergence of resistance and the risk of reaction. The aim of this study was to evaluate the prophylactic use of antibiotics in otorhinolaryngological procedures in the perioperative period.
Methods
A prospective audit of 51 patients undergoing twelve different consecutive, non-day case ENT procedures was undertaken over a 4 week period. Each patient was evaluated from the time of antibiotic commencement through their operative procedure, until the treatment was discontinued.
Results
The mean age of the patients was 32.5 years (range 3 to 80 years), of whom 23 (45%) were male. A total of 34 / 51 (66%) patients were administered 4 different antibiotics, each being prophylactic in nature. Where guidelines existed, the prescribing was non adherent in 86% of cases. The antimicrobial prophylaxis was administered at induction in 20/34 (59%), intraoperatively in 3/34 (9%) and postoperatively in 11/34 (32%) of patients. The intravenous courses prescribed were for a mean of 2.8 doses (range 1 to 15).
Conclusion
This study has demonstrated a lack of adherence to guidelines in the perioperative administration of antimicrobial agent and inappropriate timing of prophylaxis in 41% of prescribing.
Significance
This may have significant economic, infection control and medical implications.
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