Successful control program to implement the appropriate antibiotic prophylaxis for cesarean section

Author:

Fonseca Silvia Nunes Szente1,Sofia Maria Helena1,Quintana Silvana1,Nogueira Fernanda Dos Santos1,Levin Anna S.2

Affiliation:

1. Department of Infection Control, Brazil

2. University of São Paulo, Brazil

Abstract

OBJECTIVE: Describe implementation of a successful program to reduce doses (cefazolin 2 to 1 g) used for antimicrobial prophylaxis. METHODS: Evaluation of an intervention program to reduce prophylactic antimicrobial doses. The intervention included weekly staff discussions, automatic dispensation of 1g-vial of cefazolin by the pharmacy unless expressly requested by surgeon and increase in post-discharge surveillance as a strategy to reassure surgeons of the safety of the reduction. In the pre and post intervention periods, a prospective study of antimicrobial consumption and surgical site infections were measured. RESULTS: There were 5,164 and 5,204 deliveries in 2001-2002 and 2003-2004, respectively; 1,524 (29.5%) and 1,363 (26%) were cesarean sections. There was a 45% decrease in cefazolin vials used on average per cesarean section (2.29 to 1.25). Patients evaluated increased from 16% to 67% and the SSI rates in both periods were 3.34% to 2.42%, respectively. CONCLUSION: An ample intervention, including administrative and educational measures, led to high compliance with dose reduction and saved more than US$4,000 in cefazolin, considered important because government reimbursement in Brazil for cesarean section is $80.

Publisher

FapUNIFESP (SciELO)

Subject

Infectious Diseases,General Medicine

Reference27 articles.

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4. Epidemic of cesarean sections in Brazil;BARROS F.C.;Lancet,1991

5. Rates and implications of cesarean sections in Latin America: ecological study;BELIZAN J.;Brit. med. J.,1999

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