Antibioticoprofilaxia em cirurgias de vias biliares: análise epidemiológica retrospectiva no Hospital Universitário Alcides Carneiro - HUAC/UFCG.

Abstract

The surgical site infections are one of the most common causes of surgical complications, and antibiotic prophylaxis considered one of the main preventive measures against these complications. The decision to use prophylactic antibiotics should be based on the weight of evidence of potential benefit in relation to the weight of evidence of possible adverse events. Improper use of prophylactic antibiotics increases the rate of infection and implies an unnecessary cost. Improper use of an antimicrobial determines, in addition to the immediate consequences of misuse in specific patient, an important commitment for the entire hospital community, it may produce or worsen the effects of bacterial resistance. Antibiotic prophylaxis is indicated when there is a high risk of wound infection, or in the case of serious consequences if there is infection. Generally prophylaxis is not recommended in clean surgeries, but potentially contaminated surgery, especially in patients at higher risk such as the elderly, immunocompromised and diabetic, and contaminated surgeries. An antimicrobial prescription analysis is important to improve the care of the surgical patient. Your misuse causes damage to the morbidity and mortality of patients and treatment costs to the hospital. OBJECTIVES: to characterize the use of prophylactic antibiotics in surgery of the biliary tract occurred at the University Hospital Alcides Carneiro. METHODS: A retrospective, observational study with descriptive approach. The study was done by analyzing medical records records of surgeries occurred between June 2014 and June 2015. RESULTS: During the study period there were 152 surgeries after applied exclusion criteria, the sample consisted of 102 surgeries, 62 conventional cholecystectomy and 40 laparoscopic cholecystectomy. It was performed antibiotic prophylaxis with cefazolin in 93.5% of conventional cholecystectomy and 90% of cholecystectomy by video. The dose of cefazolin was 2 grams, 89.2% of the procedures analyzed. In 88.2% of cases the antibiotic was administered at the time of anesthesia induction. The duration of surgery was recorded in only 30.4% of files; none of them exceeded three hours, so it was not necessary replication dose. The diagnosis was cholelithiasis in 93.1% of cases. CONCLUSION: There was prescription when it was not necessary in 34.3% of the analyzed surgeries. It is very important joint work between the surgical team and the Hospital Infection Control Center HUAC for the implementation of surgical antibiotic prophylaxis protocols updated. Furthermore, it is important encouragement and guidance team for proper recording of data in the chart.