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 25 February 2018

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News

Antibiotic prophylaxis overused in elective colorectal surgery

A significant proportion of surgeons administer excessive and unnecessary doses of antibiotics in elective colorectal surgery, according to research published in the latest issue of the Australian and New Zealand Journal of Surgery.

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Investigators from Selangor, Malaysia, assessed the pattern of prophylactic antibiotic utilization in elective colorectal surgery.

They also determined if evidence-based medicine is employed in relation to this practice.

A cross-sectional study encompassing general surgeons performing elective colorectal surgery was performed.

Questionnaires were distributed to 144 surgeons (national, academic, and private healthcare).

Questions pertaining to the type, timing, and duration of antibiotic administration were asked.

The prevalence of wound infection audit rate, and whether or not there were specific guidelines related to antibiotic administration, were also determined.

The response rate obtained was 67% (n = 96).

72% of surgeons used more than a single-dose of antibiotics.
Australian and New Zealand Journal of Surgery
Although evidence from the current medical literature and recommended national guidelines support the use of single-dose prophylactic antibiotics, 72% of the respondents used more than a single dose.

The authors found that 42% of surgeons claimed that their prescribing practice was supported by the medical literature.

A further 32% of respondents claimed that they based their practice on hospital guidelines, and personal preference was cited as a reason by 22% of surgeons.

The remaining 4% of respondents used a similar scheduling policy to that practiced by their colleagues in relation to antibiotic administration.

There was found to be no significant difference in antibiotic dose scheduling between national, private, and university academic institutions.

Yunus A. Gul, of the University Putra Malaysia, said on behalf of colleagues, "These results suggest that a significant proportion of surgeons administer excessive and unnecessary doses of antibiotics in elective colorectal surgery."

"Further studies are required to uncover the reasons, but lack of appropriate guidelines and failure to exercise evidence-based medicine are major factors that account for this practice," it was concluded.

Aust NZ J Surg 2002; 72(4): 275-8
14 May 2002

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