Single Pre-surgical Dose of Antibiotics Found Sufficient

A single dose of antibiotics prior to surgery appears to prevent infections occurring at the surgical site as effectively as a 24-hour dosing regimen and with reduced antibiotic costs, according to a new study.

Researchers from Hospital Sao Francisco (Sao Paolo, Brazil) studied infection rates before and after the implementation of a one-dose prophylactic antibiotic protocol. Under the new protocol, for most procedures, patients were given one 1-gram dose of cephazolin at the same time anesthesia was administered. The protocol was approved by surgeons prior to implementation. The researchers then examined infection rates and costs for 6,140 consecutive patients who had surgery between February 2002 and October 2002 under the 24-hour protocol, and 6,159 consecutive patients who had surgery between December 2002 and August 2003, following the implementation of the one-dose protocol.

Surgical site infections occurred in 2% of surgeries performed under the 24-hour protocol and in 2.1% of surgeries performed under the one-dose protocol. The number of vials of cephazolin purchased decreased from 1,259 in the first time period to 467 in the second, a 63% decline that represented a monthly cost savings of U.S.$1,980 for this drug alone. The findings were published in the November 2006 issue of Archives of Surgery.

"We were able to demonstrate that one-dose prophylaxis is feasible,” said lead author Silvia Nunes Szente Fonseca, M.D., M.P.H. "We decided to reduce all antibiotic prophylaxis to one dose because this measure could safely promote savings for our institution. In this era of restricted hospital budgets and increased bacterial resistance, one-dose prophylaxis may provide a way to improve performance by lowering costs.”

Prophylactic antibiotics have been shown to decrease the occurrence of infection at the site of the surgery. However, due to rising health care costs and concerns about antimicrobial resistance, hospitals have been under pressure to use fewer antibiotics.



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