Background: Perioperative antimicrobial therapy has demonstrated efficacy in reducing the
rate of surgical site infections in clinical trials. With the emergence of antibiotic resistance,
the risk of reaction, and the inevitable financial repercussions, use of prophylactic antibiotics
is not a panacea, and their misuse may have considerable implications. The aim of this study
was to assess the use of antibiotics in the perioperative period in both general and vascular
surgery procedures.
Methods: A prospective study was undertaken of 131 patients with a mean age of 43 years
(range one month–88 years), of whom 68 (51%) were male, who underwent twenty-seven different
general or vascular surgery procedures over a four-week period. Each patient was evaluated
from the time of antibiotic commencement through their operative procedure until the
treatment was discontinued.
Results: A total of 73 patients (54%) received ten antibiotics, with 71 (97%) of these uses being
prophylactic. Of the 15 appendectomies performed for uncomplicated appendicitis, the
mean number of prophylactic antibiotic doses was 5.3 (range 1–12). Where they were documented,
written postoperative directives were not adhered to in 18/27 prescriptions (66%).
Conclusion: This study has demonstrated a lack of adherence to guidelines in the perioperative
administration of antimicrobial agents. In addition, it calls attention to the economic
implications of unnecessary prophylaxis.
