Prophylactic antibiotic practices for colectomy in Michigan

Abstract

Background: Although there are guidelines for prophylactic intravenous antibiotics in colorectal surgery, the objective of this study was to determine the extent to which these guidelines are followed.

Methods: Twenty-seven Michigan hospitals participated in a colectomy quality-improvement project. In addition to the American College of Surgeons-National Surgical Quality Improvement Program variables, these hospitals collect 25 additional data points on processes of care for colectomy cases.

Results: From 2007 to 2009, 3,002 patients had colectomy surgery and were eligible for analysis of antibiotic practices. Prophylactic antibiotics were given in 99.5% of cases; 81.4% of antibiotic choices were Surgical Care Improvement Project-compliant, and 90.8% of dosing was within 60 minutes before surgical incision. Recommended weight-adjusted dosing was performed in 56.8% of cases, and only 6.0% of antibiotics were redosed appropriately. Practices varied by hospital.

Conclusions: Prophylactic antibiotic use for colectomy in Michigan hospitals did not conform to recommended practices. These findings hold the promise for targeted quality-improvement initiatives.