Prevention of infectious complications by reducing prophylactic administration of antibiotics and observing the hygienic and epidemiologic policies of the intensive care unit
Spatenková, V.; Suchomel, P.; Bohunová, Z.
Rozhledy V Chirurgii Mesicnik Ceskoslovenske Chirurgicke Spolecnosti 81(11): 577-581
2002
ISSN/ISBN: 0035-9351 PMID: 12577540 Document Number: 547382
The authors investigated in a prospective one-year study the incidence of nosocomial infections in patients hospitalized at the intensive care unit with reduced prophylactic administration of antibiotics and adherence to the hygienic epidemiological regime. At the intensive care unit of the Neurocentre of the Liberec Hospital nosocomial infection were investigated during the prophylactic administration of antibiotics, most frequently in one dose for a maximum of 24-48 hours. For therapy antibiotics were indicated in proved or suspected bacterial infection. They were not administered in case of colonization of the patient. Concurrently the hygienic and epidemiological regime was ensured. It involved adherence to cleanliness, disinfection, in particular hygienic disinfection of the hands, sterilization, barrier nursing techniques, single-use equipment, closed systems, enhanced regime in case of colonization of the patient with resistant strains and introduction of standard procedures. The one-year prospective study comprised 529 patients hospitalized at the intensive care unit at the age of 9 to 85 years with a mean hospitalization period of 4.9 days. 57.1% patients had cerebral diseases, 31.9% diseases of the vertebral column, and other diagnoses accounted for 11%. A total of 78% patients were operated. Antibiotics were administered prophylactically to 76% patients. In the majority this was in conjunction with the surgical operation (98%). To 93% patients the antibiotic was administered only in one dose, only to 3% patients it was administered for 24 hours and to 4% patients for 48 hours. For therapy antibiotics were administered to 10% patients, including 2% patients where treatment was started at another department. Nosocomial infections were recorded in 5.4% patients. Most frequently infections at the site of operation were involved (2.5%) and infections of the urinary pathways (2.1%). Infections of the airways were recorded in 0.8% patients and infections of vascular catheters were not recorded at all. Adherence to the hygienic and epidemiological regime and rational administration of antibiotics leads at intensive care units to a reduced incidence of nosocomial infection and thus to reduced financial costs.