• Sung-Ching Pan, Hsin-Yun Sun, Jou-Wei Lin, Ching Lin, Tai-Shuan Lai, and Shan-Chwen Chang.
• Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Taipei, Taiwan.
• J Formos Med Assoc. 2008 Mar 1; 107 (3): 218-24.

Background/PurposeTo evaluate the effect of a form recording the timing of prophylactic antibiotic administration, antibiotics used, and treatment duration on the proper use of prophylactic antibiotics in patients undergoing four types of operations.MethodsThis was a retrospective study in a 682-bed, university-affiliated, tertiary teaching hospital. Using the form developed, nurse practitioners recorded the timing of prophylactic antibiotic administration, antibiotics used, and treatment duration for patients undergoing three types of clean operations (total hip replacement, total knee replacement, thyroidectomy) and one type of clean-contaminated operation (hemorrhoidectomy). Patient records were identified by chart review after searching the hospital database. A case was defined by a principal or secondary procedure code for the four types of operations. Patients who received therapeutic antibiotics for documented preoperative infection were excluded.ResultsA significant improvement (p<0.001; OR, 33.768; 95% CI, 4.304-264.951) in the use of prophylactic antibiotics was noted between the pre-intervention and intervention periods. Among the three criteria of antibiotic usage, the improvement in the appropriate timing of prophylactic antibiotics was significant (p<0.001; OR, 46.247; 95% CI, 5.891-363). The accuracy of the prophylactic antibiotic form in recording the timing of antibiotic administration, the choice of antibiotics, and the treatment duration was 84.2% (16/19), 89.4% (17/19), and 100% (19/19), respectively.ConclusionThe prophylactic antibiotic form effectively decreased the inappropriate use of prophylactic antibiotics. Due to its high degree of reliability, this infection control measure can be used as a continuous monitoring system for prophylactic antibiotic use.

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