Perioperative chemoprophylaxis in obstertics and gynecology in Croatia and Greece

Aim: The aim of the present study was to compare the status of Chemoprophylaxis in the Departments of Obstetrics and Gynecology of two University Hospitals in Croatia and Greece, and to check if general guidelines for Chemoprophylaxis in Obstetrics and Gynecology are met. Study Design: The 1st Clinic of Obstetrics and Gynecology of Aristotle University of Thessaloniki (Greece) and the Clinic of Obstetrics and Gynecology of the University Hospital Rijeka (Croatia) participated in the study. The Croatian and Greek gynecologists replied to the same questionnaire, which investigated the conformance to general guidelines and the behavior of the surgeons in peri-operative Chemoprophylaxis in patients having a low or a high risk for a post-operative infection. The following issues in Chemoprophylaxis were checked: 1) application of chemoprophylaxis, 2) duration and time of initiation of chemoprophylaxis and 3) the kind of antibiotics used. Results: The Greek surgeons usually applied two doses of a second generation cephalosporin, in both gynaecologic and obstetric surgery. They usually initiated chemoprophylaxis during the induction of anesthesia, except for cases that demanded chemotherapy before surgery. In some cases with a high risk for a post-operative infection, Greek surgeons used also metronidazole, doxycycline and netilmicin. The Croatian surgeons usually used cefuroxime or cefazolin for chemoprophylaxis, and in cases of high danger they used also metronidazole, doxycycline and azithromycin. Chemoprophylaxis was initiated during or after the operation, and its duration depended on the risk for a post-operative infection. Conclusions: Greek gynecologists showed a better conformance to guidelines for peri-operative chemoprophylaxis. Non-conformance to the guidelines was sometimes observed in both Greek and Croatian gynecologists.