Tuesday, February 22, 2005

Prophylactic antibiotics in Surgical Patients

A large survey published in the February 2005 Archives of Surgery reported that 99% of Medicare patients undergoing any of the five surgical procedures they reviewed received prophylactic antibiotics.1% developed wound infections. 92 % received antibiotics in compliance with published guidelines. Areas that the authors suggested could be problem areas were : possibly as many as 60 % received antibiotics for periods longer that some would say is optimal, possible overuse of vancomycin, and not all received the antibiotics within the usually recommended one hour of incision (Although, the exact time of incisions was frequently not recorded so this data is a bit soft) . The authors admited that their vancomycin-use analysis was limited by the fact they had no information about the frequency of MRSA in the various hospitals. These criticisms notwithstanding the apparent bottom line is there seems to be a very low incidence of sugical site infections. Duration of antibiotic therapy continues to be an area with more opinion that data. Critics of health care won't find much about which to express alarm but they will find something.


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