A controlled Intervention Study: Comparison of Intervention on the Antibiotic Prophylaxis of Three Clean Surgeries in Chinese Tertiary Hospitals

A controlled intervention study was to promote rational antibiotic prophylaxis in clean surgeries in Chinese tertiary hospitals from 2008 to 2009. The effect of the intervention was measured and compared before and after intervention (intervention group, IG, including twelve hospitals), and compared with the control group (CG, including 164 tertiary hospitals distributed in 31 provinces). There were a total of 3961 and 657 cases identified in IG & CG for the study. Comparing the changes of IG with CG following the 3rd intervention, the proportion of antibiotics use without indication decreased from 61.9% (IG) & 84.4% (CG) (χ2 test, P < 0.01) to 60.9% (IG) & 59.1% (CG) (χ2 test, P > 0.05); the rationality scores increased from 55.4 (IG) & 57.6 (CG) (t test, P > 0.05) to 77.0 (IG) & 64.3 (CG) (t test, P < 0.01) respectively. The results showed that the main problems of irrational antibiotic prophylaxis included antibiotic selection, medication given at wrong time, and the long duration of medication, accounting for 28.1%, 34% and 69.6% of the total indicated cases respectively. Significant improvements in using antibiotics with indication would help enhance rational use of the antibiotics. There were complicated factors affecting the antibiotics use decision making beyond the capacity of technical interventions.