Antibiotic Use on the Surgical Services of Two Jerusalem Hospitals, as Determined by Surveillance and Influenced by an Intervention Program

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Abstract
The use of antimicrobial drugs on the surgical services of two hospitals in Jerusalem, Israel, was surveyed prospectively. At one hospital (C), the use of these drugs was controlled; at the other (N), the use was not controlled. At both hospitals the cephalosporins accounted for ∼21 % of the antimicrobial drug-group courses (AMOGCs); however, they accounted for only 11% of the antimicrobial days (AMOs) at C but 22% at N. Prophylaxis after surgical procedures accounted for the initiation of 36% and 33% of the AMOGCs at C and N, respectively. The geometric mean of the duration of prophylactic courses of drug therapy was 3.2 days at C and 3.9 days at N (P< 0.01). Excessively prolonged prophylaxis accounted for ∼61% (388 AMOs) of prophylactic use at Nand 55% (646 AMOs) at C. At C the proportion of patients receiving prophylaxis in high-risk surgical operations increased from 39% to 97% after the introduction of protocols for prophylaxis, but the average quantity of antimicrobial drugs administered per patient decreased by 38%.

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