Kartlegging av antibiotikaprofylakse ved primær kne- og hofteprotesekirurg

Abstract

Background: Antibiotic prophylaxis contributes to the reduction in incidence of surgical site infection (SSI) in primary knee and hip replacement. It is an increased awareness about proper antibiotic use and antibiotic resistance. As a result of this new national guideline came in 2013 where a more cautious use of antibiotics is desired. Purpose: Study the compliance to national guidelines for antimicrobial prophylaxis in primary knee and hip replacement. The use of antibiotics was compared with the national guidelines on antibiotic choice, dose, timing of the first dose, duration of prophylaxis and dosing interval. Material and methods: This was a retrospective study of 229 patients undergoing primary knee and hip replacement at St. Olavs Hospital Trondheim, Røros and Orkdal. By reviewing anaesthetic and medical records, and medication charts. Results: Antibiotic choice, dose, timing of the first dose, duration of prophylaxis and dosing interval were compliant with the guideline in 98,3 %, 98,2 %, 54,7 %, 98,7 % and 88,3 %. Overall compliance to all parameters of the national guideline was 47,6 %. Conclusions: Compliance to separate aspects of the guideline for surgical prophylaxis is favourable, the overall compliance to all parameters is modest. Especially the parameter timing of the first dose needs improvement. Relevance: Inappropriate use of surgical antimicrobial prophylaxis can select for resistant microorganisms. The national guideline will ensure appropriate use of antibiotic. Therefore an optimal compliance with the guideline is important to reduce inappropriate use of antibiotic.