Abstract
Antimicrobial agent administration during surgery is important for prophylaxis against surgical site infection. The infection control team of our hospital recommends administration of cefazolin (CEZ) or cefmetazole (CMZ) every 3 hours during surgery. However, appropriate administration was frequently not provided in surgery extending over 6 hours. We changed the supply of an antimicrobial agent from “provided by prescription” to “administered by all staff in the operation area” to improve compliance with the recommendations. In addition, “form stamps” were provided to control administration in each care unit. Administration of antimicrobial agents during surgery extending over 6 hours was retrospectively studied before (August 2005) and after (August 2006) change of the supply system, and after introducing the electronic medical recording system (August 2007). Total surgeries were 45, 46 and 44 cases, and mean operation times were 483, 524 and 510 min (p=0.46), respectively. The recommendations required 99, 114 and 106 doses, whereas the actual provisions were 20 (20.2%), 101 (88.6%) and 104 doses (98.1%), respectively (p<0.001). The mean interval between administrations was 181 min and extended over 210 min in only 2 cases. The change in supply methods including form stamps and other interventions dramatically improved antimicrobial agent administration during extended surgery.
