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KMID : 0984720040360010024
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Infection and Chemotherapy
2004 Volume.36 No. 1 p.24 ~ p.31
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Usage Analysis of Surgical Prophylaxis of Cephalosporins and Aminoglycosides in a University Hospital
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Rheem In-Soo
Pai Hyun-Joo
Choi Eun-Kyoung
Oh Hyung-Tae
Choi Dae-Ok
Park Woo-Sung
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Abstract
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Background : According to previous investigation on antibiotic use at Dankook University Hospital, cephalosporin and aminoglycoside were the most commonly used antibiotics accounting for 52.8% and 30.4% of total antibiotics used, respectively. In almost all cases, antibiotics were prescribed for prophylaxis rather than for treatment the ratio for prophylaxis vs. treatment intent was 3.9 : 1 and 3.6 : 1 for cephalosporin and aminoglycoside, respectively. Thus, we performed a study to investigate the current usage of cephalosporin and aminoglycoside before and after the surgical procedures.
Methods : We retrospectively analyzed the appropriateness of prophylactic use of antibiotics on 14 major operative procedures (26.4% of total operations) for patients discharged during July, 1997.
Results : Among 8 kinds of operative procedure performed on 105 cases, in which prophylactic antibiotic use was recommended, appropriate antibiotic use was observed in only 2 cases of non- perforating appendectomy. For 7 operative procedures, in which use of 1st generation cephalosporin is recommended, 1st cephalosporins were used only on 37.8% (44/92) of cases, whereas 2nd cephalosporins were used for most of other cases. An average of 2.5 DDD of 2nd cephalosporin, which was a pertinent dose, was used on non-perforating appendectomy. However, on all the other 7 operative procedures, the dose exceeded the recommended dose. Inappropriate antibiotic use was observed for 6 operative procedures, for which prophylactic antibiotic use was not recommended. The combination of cephalosporin and aminoglycoside was used in all but 3 types of operative procedures.
Conclusion : During most of the pre- and post-operative period, antibiotics were combined, overused, misused, and inappropriately used.
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KEYWORD
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Prophylaxis, Surgery, Cephalosporin, Aminoglycoside
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