Análise da profilaxia antimicrobiana para a prevenção da infecção do sítio cirúrgico em um hospital do centro-oeste brasileiro

Abstract

The purpose of this study was to analyze preoperative antimicrobial prophylaxis in clean surgery, at a university hospital in Centre-West Brazil. This cross-sectional, descriptive study was completed using 700 records of patients 18 years of age or older undergoing clean surgery between 2008 and 2010. The study used a previously evaluated, structured form for data collection. Two indicators were analyzed: antimicrobial prophylaxis within one hour of incision, and antimicrobial prophylaxis 24 hours postoperatively, considering the following variables: antimicrobial selected; dose according to the weight of the patient, additional doses during surgery, and surgical procedures taking longer than four hours. Records completed within 30 days of the surgical procedure were considered, 12 months in cases of prosthetic implants and like ones. It was found that 86.6 % had received antimicrobial prophylaxis, in 75.1%, the first dose was administered within the recommended timeframe, and in 96.9%, the antibiotic of choice was Cefazolin. Inadequacies were present in 70.6% for duration of prophylaxis, 96.8% in the dose according to the weight, and 70% in additional doses. The rate of surgical site infection was 10%, methicillin resistant Staphylococcus aureus was the most common etiologic agent. Despite guidelines that advise caution with regard to antimicrobial prophylaxis, the study found inadequacies that may negatively impact patient safety.