國家衛生研究院 NHRI:Item 3990099045/1908
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    題名: Use and abuse of surgical antibiotic prophylaxis in hospitals in Taiwan
    作者: McDonald, LC;Yu, HT;Yin, HC;Hsiung, AC;Ho, MT
    貢獻者: Division of Clinical Research;Division of Biostatistics and Bioinformatics
    摘要: 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.
    關鍵詞: Medicine, General & Internal
    日期: 2001-01
    關聯: 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
    顯示於類別:[何曼德(1997-2002)] 期刊論文
    [熊昭] 期刊論文
    [McDonald LC(1998-2000)] 期刊論文

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