Skip to content


We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact us so we can address the problem.

Characteristics and institutional initiatives that improve the surgical antibiotic prophylaxis use

  • 1 and
  • 1
Antimicrobial Resistance and Infection Control20154 (Suppl 1) :P81

  • Published:


  • Initial Time
  • Antibiotic Prophylaxis
  • High Adherence
  • Institutional Guideline
  • Lower Adherence


There is little data about adherence to surgical antibiotic prophylaxis guidelines in Brazil.


To recognize the institutional initiatives to improve antibiotic prophylaxis practices in neurosurgery.


Cross-sectional observational study, carried out with a population consisting of hospitals, medical records of neurosurgical patients, Infection Control Team (ICT), surgical team. The sample of hospitals and surgical team was used for convenience and the records for each hospital was calculated based on 40% of overall adherence.


Among the nine assessed hospitals, five achieved quality certification in 2010. The mean weekly hours of ICT per hospital bed and per critical bed was 0.7 and 3.8. Eight hospitals disclosed SSI rates, seven stratified by surgical specialty, six created the antibiotic prophylaxis guidelines with the surgeons’ approval; in four the recommendations were disseminated. Of the 1,011 neurosurgeries 38 were excluded due to lack of records. Overall adherence was 10.0%. The administration route was appropriate in 100%, dose in 90.6%, indication in 90.0% and time of onset in 77.1%. There was a lower adherence regarding duration (26.1%) and a statistically significant association between hours of ICT/ICU bed (p=0.048), dissemination of surgical antibiotic prophylaxis use guidelines (p = 0.035), adherence monitoring (p = 0.024), disclosing of results (p = 0.015) and the period of the day when the surgery occurred (CI=1.7 to 6.6). Among the total of 43 anesthesiologists and surgeons interviewed more than 80% agreed with the institutional guidelines and more than 50% reported they always followed them.


The number of ICT professionals/critical bed, dissemination of guidelines, monitoring and disclosing of results are associated with higher adherence regarding antibiotic prophylaxis use; period of surgery, dose (IC 1.72 - 6.65) and initial time (IC 1.12 - 3.01) and surgery type, initial time (IC 1.24 - 4.25) and duration (IC 1.09 - 2.59). The ICT had structure as required by law, but had shortcomings regarding the process of guideline implementation, monitoring and dissemination of results.

Disclosure of interest

None declared.

Authors’ Affiliations

Medical-Surgical, University of São Paulo, São Paulo, Brazil


© Schmitt and Lacerda; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.