The ASPOC Project in neurosurgery: preliminary results from 6 European countries

Background: The ASPOC Project (ASPPOC, AntibioticSurveillance Project on Perioperative Chemoprophylaxis)is a multicentric study carried out in European countries,aiming at establishing an evidence-based perioperative che-moprophylaxis.Objectives:The aim of this study, which is part ofASPPOC, was to check conformance to the guidelines forperioperative chemoprophylaxis in Neurosurgery, and totrace out changes that must be made in European countriesto improve its quality.Methods:6 European countries participated in the study:Greece, Italy, Denmark, Serbia, Croatia and Montenegro.The conformance to the recommended guidelines and thequality of perioperative prophylaxis were checked by useof the same questionnaire in each country. The followingcriteria of quality were checked: application of periopera-tive prophylaxis, duration and time of initiation of prophy-laxis, and the kind of antibiotics used.Results:A different practice on the quality of perioperativeprophylaxis was observed in each country. The duration ofprophylaxis exceeded the maximum recommended time of24 hours in many cases in all countries except Denmark andItaly. The quality of prophylaxis was generally good in Den-mark. In Serbia, Croatia, Montenegro, Greece and Italy dis-crepancies in the duration of prophylaxis and the kind ofantibiotics were observed, with use of 3rd generation cepha-losporins—and even 4th generation cephalosporins in Croa-tia. Aminoglycosides were used in Denmark, Italy, Serbia and Montenegro.Conclusions:The conformance to the guidelines and thequality of perioperative prophylaxis were not satisfactory.Dynamic changes are required to improve the quality and establish an evidence-based perioperative prophylaxis in neurosurgery.