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Revista do Instituto de Medicina Tropical de São Paulo
On-line version ISSN 1678-9946
FONSECA, Silvia Nunes Szente et al. Successful control program to implement the appropriate antibiotic prophylaxis for cesarean section. Rev. Inst. Med. trop. S. Paulo [online]. 2008, vol.50, n.2, pp. 79-82. ISSN 1678-9946. http://dx.doi.org/10.1590/S0036-46652008000200003.
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.
Keywords : Antimicrobial prophylaxis; Cesarean section; Compliance; Cefazolin; Surgical site infection.