"Overall, 55.7 percent of patients received prophylactic antimicrobials during the 60 minutes … before incision," the authors write. "Prior studies have demonstrated that timing is critical to the effectiveness of prophylaxis, and current guidelines recommend dosing within one hour before incision….It is of interest that 9.6 percent of the patients in our assessment received their first dose more than four hours after incision when little if any benefit would be expected based on these previously published guidelines."
"Most (92.6 percent) of the patients in this assessment received a prophylactic antimicrobial regimen consistent with current guidelines," according to the study. "However, only 78.7 percent received regimens that were limited to the recommended agents, suggesting that a substantial amount of antimicrobials are used unnecessarily."
"The results of this study raise additional concerns regarding antimicrobial resistance. Our data suggest that vancomycin continues to be used excessively for surgical prophylaxis," the authors write. "In addition, 59.3 percent of patients received prophylaxis for more than 24 hours after the end of surgery." There is evidence that use of new, broad spectrum antimicrobials and prolonged use of antimicrobials can promote antimicrobial-resistant bacteria and increase the incidence of antibiotic-associated complications, according to the article.