Prophylactic antibiotic practices for colectomy in Michigan

BackgroundAlthough 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.MethodsTwenty-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.ResultsFrom 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.ConclusionsProphylactic antibiotic use for colectomy in Michigan hospitals did not conform to recommended practices. These findings hold the promise for targeted quality-improvement initiatives.