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Antimicrobials to prevent infection in major surgery are used properly only about half the time

CHICAGO Antimicrobial medications intended to prevent surgical site infections are appropriately administered to patients (within one hour before incision) only 55.7 percent of the time, according to a study published in the February issue of Archives of Surgery, one of the JAMA/Archives journals.

Surgical site infections (SSIs) are a major contributor to patient injury, mortality and health care costs, increasing mortality rates by two to three times, length of hospital stay by an average of seven days and charges by approximately $3000, according to background information in the article. The effectiveness of antimicrobials administered shortly before skin incision for prevention of SSIs was established in the 1960s and has been repeatedly demonstrated since, the authors report. "Antimicrobial prophylaxis (preventive treatment) to prevent SSI is one of the most widely accepted practices in surgery."

Dale W. Bratzler, D.O., M.P.H., of the Oklahoma Foundation for Medical Quality, Inc., Oklahoma City, and colleagues report baseline results of an assessment of use antimicrobials to prevent SSIs for a national sample of Medicare patients undergoing five types of major surgery during 2001. The study included a random sample of 34,133 patients from 2,965 hospitals from every state, the District of Columbia and Puerto Rico. The medical records were examined to determine if the use of antimicrobials met three parameters of published guidelines for their use to prevent SSIs: whether they were given within one hour before the surgical incision; the selection of safe and effective antimicrobials consistent with current published guidelines; and their discontinuation 24 hours after surgery when the patient is no longer receiving a benefit.

"Overall, 55.7 percent of patients received prophylactic antimicrobials during the 60 minutes before incision," the authors write. "Prior studies have demonstrated that timing is critical to the effectiveness of pr
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Contact: Dale W. Bratzler
405-840-2891
JAMA and Archives Journals
21-Feb-2005


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