Τόμος 22 (2008) – Τεύχος 2 – Άρθρο 81 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Διεθνής Έκδοση – Volume 22 (2008) – Issue 2 – Article 81 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-International Edition

1. Department of Pharmacology, Medical School, Aristotle University of Thessaloniki, Greece

2. 5^th Surgery Department, Medical School, Aristotle University of Thessaloniki, Greece

3. Unit of Clinical Pharmacology, University Hospital Rijeka, Croatia

4. Department of Pharmacology, Toxicology and Clinical Pharmacology, Medical School, University of Novi Sad, Serbia

5. Department of Anesthesia and Internal Care Unit, Clinical Center Podgorica, Montenegro

6. Department of Infectious Diseases, University Medical Centre Ljubljana, Slovenia

7. Department of Clinical Pharmacology, Clinical Centre Nis, Serbia

8. 1^st Surgery Department, Medical School, Aristotle University of Thessaloniki, Greece

9. 1^st Surgery Department, Hippokrateion Hospital, Thessaloniki, Greece

10. Center of Clinical and Experimental Pharmacology, Medical School, University of Kragujevac, Serbia

11. Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Greece

12. 1^st Surgery Department, Laikon Hospital, Medical School, National and Kapodistrian University of Athens, Greece

13. Department of Pharmacology, Faculty of Medicine and Public Health, University of Verona, Italy

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Methods: 6 European countries participated in the study: Greece, Italy, Serbia, Croatia, Slovenia and Montenegro. Conformance to the recommended guidelines and quality of perioperative chemoprophylaxis were checked by use of the same questionnaire in each country. The following criteria of quality in chemoprophylaxis were checked: 1) application of chemoprophylaxis, 2) duration and time of initiation of chemoprophylaxis and 3) the kind of antibiotics used.

Results: A different practice on application and quality of perioperative chemoprophylaxis was observed in each country, and sometimes in different Surgery Departments of the same country. Chemoprophylaxis was usually initiated during pre-induction to anesthesia but its duration exceeded the maximum recommended time of 24 hours in many cases in all countries except Italy. The recommended beta-lactams (ATC code J01C and J01D) were used in most cases; metronidazole (ATC code J01XD01) or clindamycin (ATC code J01FF01) was used in cases of anaerobic contamination; vancomycin (ATC code J01XA01) was used in cases of high percentage of MRSA in hospital flora. 3rd generation cephalosporins (ATC code J01DD) were used in Serbia, Slovenia and Montenegro. Gentamicin (ATC code J01GB03) was used in some operations in Croatia and Slovenia, and amikacin (ATC code J01GB06) was used in Serbia. Ciprofloxacin (ATC code J01MA02) was also used in Slovenia.

Conclusions: The quality of perioperative chemoprophylaxis was not satisfactory, and serious inconsistencies to the recommended guidelines were observed in many cases. Dynamic changes are required in order to improve the quality and establish a successful and evidence-based perioperative chemoprophylaxis in general surgery.

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