Perioperative antibiotic prophylaxis in adults - Sistema Nazionale ...

If the recommendations indicated in the guideline are not followed (the suggestedantibiotic prophylaxis is not given or an agent not indicated in the guideline is given)the reasons should be clearly set out in the case records.RecommendationVI/A The recording of a minimum data set in the case records and treatment chartsfacilitates the performance of audits to assess the appropriateness of perioperativeantibiotic prophylaxis.Numerous methods of measuring outcome have been suggested 152 : the mostcommonly used is the rate of SSI 152 .The measurement and comparison of these rates are complicated by the fact thatdifferent groups may use different definitions of wound infection. This workinggroup suggests adopting the definition of SSI developed by the CDC/NHSN (seeAnnex 4, page ). This envisages monitoring postoperative infections one month afterthe operation; when the operation includes the insertion of a prosthetic device,monitoring should be performed one month and again one year after the operation.Key points and core indicators for audit of application of the guidelineCore indicators for audit 19,152,194,210,211Indicators of proceduresThe following must be recorded:• whether or not prophylaxis was prescribed as indicated in the local guideline;• whether or not, when the choice of prophylaxis was different from theindications in the local guideline, a clinical justification for that choice wasrecorded in the case notes and/or other case records;• whether or not the first dose of antibiotic was given within 60 minutes beforethe start of surgery;