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Revista Cubana de Medicina Militar

Print version ISSN 0138-6557On-line version ISSN 1561-3046

Abstract

CALZADILLA MOREIRA, Gilberto Vladimir; LARA FERNANDEZ, Héctor L  and  SOTOLONGO HERNANDEZ, Teresa. Perioperative antibiotic prophylaxis in the Orthopedics and Traumatology Service: Its significance. Rev Cub Med Mil [online]. 2009, vol.38, n.2. ISSN 0138-6557.

INTRODUCTION: The aim of the development of work strategies and perioperative antibiotic prophylaxis protocols is to decrease postsurgical infections. A pharmaco-economic assessment of three therapeutical options for above mentioned prophylaxis in Orthopedic Service during 2001 changed the antimicrobial policy, and the application of a performance protocol. OBJECTIVE: To know the impact of perioperative antibiotic prophylaxis in Orthopedic and Traumatology Service of "Dr. Luis Díaz Soto" Higher Institute of Military Medicine during 2000-2006. METHODS: We performed a cross-sectional, retrospective and descriptive study based on design of drugs use study with a therapeutical scheme and practical consequences. Protocol fulfillment was assessed by individual pharmacologic profile. Consumption evolution, antibiotic expense, and postoperative infection behaviors, bacterial resistance, and microbiological map were assessed by means of the trend analysis. RESULTS: Protocol fulfillment was appropriate in 90, 8 % of patients. Main violations were related to treatment length. There was an increment in Cefazolin consumption (from 0,10 DDD in 2000 to 0,71 DDD in 2006); in the remainder antibiotics, trend decreased. There was an expense increment by Cefazolin ($ 3 536, and 2006 of $ 41 942). Trend of infection rate in surgical site showed a decrease in all the localizations, whereas the bacterial resistance in 2000 was of a 56 %, and decreased in 2006 to a 48 %. CONCLUSIONS: Impact of application of perioperative prophylaxis protocol was positive, achieving a high level of fulfillment. The proper fulfillment of antibiotic prophylaxis standard with Cefazolin allowed a decreasing trend in antibiotic consumptions and expenses. Infection in surgical site and the bacterial resistance showed the same decreasing trend and a positive correlation.

Keywords : Postsurgical infection; antibiotic prophylaxis; impact..

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