國家衛生研究院 NHRI:Item 3990099045/1908

NHRI > National Institute of Infectious Diseases and Vaccinology > Monto Ho(1997-2002) > Periodical Articles > Item 3990099045/1908

Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/1908

Title:	Use and abuse of surgical antibiotic prophylaxis in hospitals in Taiwan
Authors:	McDonald, LC;Yu, HT;Yin, HC;Hsiung, AC;Ho, MT
Contributors:	Division of Clinical Research;Division of Biostatistics and Bioinformatics
Abstract:	Background and purpose: A large proportion of antibiotics used in hospitals is for surgical prophylaxis. We determined the prevailing practices and factors associated with the misuse of surgical antibiotic prophylaxis in hospitals in Taiwan. Methods: In a systematic survey of the medical records of 629 patients from 14 hospitals who underwent clean or clean-contaminated surgery from September 1998 through March 1999, data on the timing and duration of, and reasons for, antibiotic use were collected and analyzed. Results: Overall, 578 (92%) patients received antibiotics perioperatively; in 499 (79%) cases, antibiotics were used for surgical prophylaxis. Only 302 (61%) patients received prophylaxis within 1 hour before surgery. More than 70% of patients received more than 3 days of postoperative antibiotic prophylaxis. The most commonly used antibiotics were first-generation cephalosporins and aminoglycosides. Factors independently associated with inappropriately timed prophylaxis included surgery performed at a hospital with a greater proportion of intensive care unit beds (conditional odds ratio [OR] = 1.14 per 1% increase, 95% confidence interval [CI95%] 1.06-1.23; p < 0.01), surgery duration of at least 1 hour (OR = 0.40, CI95% 0.24-9.67; p < 0.01), orthopedic surgery (OR = 0.59, CI95% 0.36-0.98; p = 0.041), and cardiothoracic surgery (OR = 2.07, CI95% 1.14-3.77; p = 0.02). Risk factors for more than 3 days of prophylaxis included surgical placement of prosthetic material (OR = 2.26, CI95% 1.10-4.64; p = 0.03), the number of antibiotics used (OR = 1.99 per antibiotic, CI95% 1.26-3.13; p < 0.01), surgery duration of at least 1 hour (OR = 3.07, CI95% 1.45-6.51; p < 0.01), neurosurgery (OR = 4.57, CI95% 2.24-9.31; p < 0.01), and the use of oral antibiotics together with intravenous drugs (OR = 20.72, CI95% 10.72-40.07; p < 0.01). Conclusions: The results of this survey indicate that inappropriate use of surgical antibiotic prophylaxis is common in hospitals in Taiwan. Our results identify several problem areas, including incorrect timing, duration, and use of oral antibiotics for surgical prophylaxis, that require targeted physician education and public health interventions.
Keywords:	Medicine, General & Internal
Date:	2001-01
Relation:	Journal of the Formosan Medical Association. 2001 Jan;100(1):5-13.
Link to:	http://www.fma.org.tw/fagmag/pdfiles/100_1/100-1-5.pdf
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0929-6646&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:000168655900001
Cited Times(Scopus):	http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=0035102772
Appears in Collections:	[Monto Ho(1997-2002)] Periodical Articles [Chao A. Hsiung] Periodical Articles [McDonald LC(1998-2000)] Periodical Articles

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