MONDAY, Nov. 20, 2006 (HealthDay News) --A single dose of antibiotics before surgery seems to prevent surgical site infections just as well as doses given over 24 hours, Brazilian researchers report.
The finding could save hospitals money while offering patients the same level of protection, experts say.
"We were able to demonstrate that one-dose prophylaxis is feasible," wrote a team from the Hospital Sao Francisco, Ribeirao Preto, Sao Paolo, in the November Archives of Surgery. "In this era of restricted hospital budgets and increased bacterial resistance, one-dose prophylaxis may provide a way to improve performance by lowering costs," the experts concluded.
Infection after surgery remains a common complication, but giving patients antibiotics before surgery reduces the chances they will develop an infection at the surgical site.
However, rising health care costs and concerns about antibiotic-resistant bacteria have put hospitals under pressure to use fewer antibiotics. While most guidelines call for only one dose of antibiotics before surgery, some surgeons don't comply with this recommendation. Instead, patients get multiple doses of broad-spectrum antibiotics that target many types of bacteria, rather than the recommended narrow-spectrum drugs.
To find out which strategy is better, a team led by Dr. Silvia Nunes Szente Fonseca tracked infection rates before and after the start of the hospital's one-dose antibiotic protocol.
The researchers compared infection rates and costs for over 6,100 consecutive patients who underwent surgery between February 2002 and October 2002 and nearly 6,200 consecutive patients who had surgery between December 2002 and August 2003, after the start of the one-dose protocol.
They found no difference in infection rates. Specifically, surgical site infections occurred in 2 percent of the surgeries performed under the 24-hour protocol and in 2.1 percent performed under the one-dose protocol. Moreover, by cutting back on their need for antibiotics, the hospital saved $1,980 per month after implementing the new policy.
One expert believes the results are promising but need to be replicated in U.S. hospitals before any definite conclusion can be drawn.
"I think that the paper is a step in the right direction," said Dr. Philip Tierno, the director of clinical microbiology and immunology at New York University Medical Center and author of The Secret Life of Germs and Protect Yourself Against Bioterrorism. Tierno is also a member of the Infection Control Committee at the medical center.
Tierno noted that, in the Brazilian study, the switch to one-dose protocol had no effect on infection rates and "resulted in a 66 percent cost savings to the institution."
"However, I think that there are some surgeries that are inherently more at risk for development of infection like heart, bone, GI and colon, such that, some institutions may elect to exclude those surgical procedures from the one-dose protocol," Tierno added. "I'd like to see other institutions, especially some in the U.S., confirm these studies," he said.
More information
Find out more about surgical infections at the Institute for Healthcare Improvement.
