| Title | Adherence with guidelines of perioperative antibiotic prophylaxis and cost among women undergoing cesarean section | |
| Authors | Eleni Apostolopoulou, Nikolaos Zaxos, Aikaterini Georgoudi, Maria Tsakona and Panagiota Nikoloudi
Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Hellas |
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| Citation | Apostolopoulou, E., Zaxos, N., Georgoudi, A., Tsakona, M., Nikoloudi, P.: Adherence with guidelines of perioperative antibiotic prophylaxis and cost among women undergoing cesarean section, Epitheorese Klin. Farmakol. Farmakokinet. 24(1): 19-24 (2010) | |
| Publication Date | Accepted for publication (Final Version): April 10, 2010 | |
| Full Text Language | English | |
| Order – Buy | Ηλεκτρονική Μορφή: pdf (10 €) – Digital Type: pdf (10 €)
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| Keywords | Guidelines, surgical infection, prevention, compliance, antimicrobial prophylaxis, caesarean section. | |
| Other Terms | review article | |
| Summary | The purpose of this study was to assess the adherence of obstetricians with the guidelines and the cost of antimicrobial prophylaxis. This study was held from January 2008 until May 2009 in an obstetric department in a general hospital in Athens, Greece. A total of 112 women undergoing caesarean section were studied. Data were collected by using an anonymous standardized survey record form. Patient data consisted of I) demographic characteristics: age, length of stay, type of CD procedure and duration of CD procedure II) risk factors: Infection at admission, diabetes mellitus, hypertension, premature rupture of membranes (PROM) and III) data for antibiotic agent, the timing of administration, and the duration of prophylaxis. During the study period 112 CDs were performed. The mean duration of CD procedure was 47±18.22 min. The mean duration of antimicrobial prophylaxis was 4.56±1.72 days. The majority of CD procedure (89.3%) defined as emergency operations and the 10.7% as elective operations. The most frequently prescribed categories of antibiotics were penicillins and cefalosporins. Antibiotic prophylaxis was indicated in 89.3% of patients, but in our survey, it was administered to 100% of patients so it was inappropriately given to 11%. From process indicators the utilization indicator of antibiotic prophylaxis was 7% (7/100) and the timing indicator was 0%. In addition, the use of antibiotic prophylaxis was misuse in 93%, and overuse in 100%. From the evaluation of the process indicators, it was concluded that the overall compliance rate of obstetricians was 0%. Patients received in total 2,774 doses of prophylaxis and the total cost was € 20,034. The cost per CD procedure was €178,875. In conclusion, the cost of antibiotic prophylaxis was high, which is a very important parameter in hospital. The adherence of obstetricians and anesthesiologists with guidelines for surgical prophylaxis must be improved. The education and discussion of our results with surgical team, infection control committee and neonatology department will contribute to increasing the adherence with prescribing and administering perioperative antimicrobial prophylaxis, reducing the antimicrobial cost and establishing a policy that will preserve the safety of the mother and infant without increasing the cost of neonatal care. | |
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