Τόμος 22 (2008) – Τεύχος 2 – Άρθρο 82 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Διεθνής Έκδοση – Volume 22 (2008) – Issue 2 – Article 82 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-International Edition

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

2. 2^nd Department of Neurosurgery, Medical School, Aristotle University of Thessaloniki, Greece

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

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

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

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

7. 1st Department of Neurosurgery, Medical School, Aristotle University of Thessaloniki, Greece

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

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Methods: 5 European countries participated in the study: Greece, Italy, Serbia, Croatia 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 even among different Neurosurgery 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. Discrepancies in the kind of preferred antibiotics was observed in all countries, with use of 3rd generation cephalosporins (ATC code J01DD) – and even 4^th generation cephalosporins (ATC code J01DE) in Croatia. Aminoglycosides (ATC code J01GB) were also used in Italy, Serbia and Montenegro.

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 neurosurgery.

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