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Need the 'Cost' Be So High?

Donald E. Fry, MD; Phil J. Harbrecht, MD; Hiram C. Polk, Jr, MD

Arch Surg. 1981;116(4):466-469.

Abstract
• To assess compliance with accepted principles, the use of prophylaxis with systemic antibiotics in selected specialty procedures was examined. The operations reviewed were aortofemoral bypass, pulmonary resections, open-hip procedures, and head-neck cancer procedures that involve the oropharyngeal cavity. Of all patients, 74% received antibiotics preoperatively and 79% received prophylaxis with antibiotics longer than 24 hours postoperatively. Evaluated against the criteria of preoperative initiation and limited postoperative administration (24 hours), only 10% of the patients received appropriate prophylaxis. A 3% incidence of drug-associated complications was identified; each patient with complications had received antibiotics for a prolonged time postoperatively. Reduction in the length of postoperative prophylaxis with systemic antibiotics will reduce (1) the number of drug-associated complications, (2) selection pressures on the hospital microbial population, and (3) needless expense in hospitalized patients.

(Arch Surg 1981;116:466-469)

Author Affiliations
From the Department of Surgery, Veterans Administration Medical Center, and the Department of Surgery, University of Louisville School of Medicine, Louisville, Ky.

Footnotes
Accepted for publication Sept 30, 1980.

Read at the Fourth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Alexandria, Va, May 14, 1980.

Reprint requests to the Department of Surgery, Veterans Administration Medical Center, 800 Zorn Ave, Louisville, KY 40202 (Dr Fry).

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