Prophylactic antibiotics in surgery. Practices within surgical services of the Veterans Administration

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Abstract
A survey of prophylactic antibiotic-prescribing habits among chiefs of surgical services of the Veterans Administration [VA] yielded a 99% response. These responses were compared with guidelines set by an expert committee on antimicrobial use for the VA central office. Asssuming that 100% concordance with the standards of the committee is a desired state, the average hospital is approximately 1/3 away from this goal (average score, 62.4%). The majority of errors were those of overuse rather than underuse. The size of the service and the existence of a university affiliation had no influence on the results. Feedback to the chiefs of service regarding the use of antibiotics was informal and tended to be carried out on rounds rather than as a result of formal audits. Most senior surgeons indicated that they would be willing to be influenced by audit guidelines.

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