Vladivostok Surgeons Use Evidence-Based Medicine to Curb Infection Rates

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Infection rates following surgery at City Clinical Hospital No. 2 in Vladivostok, Russia soared between 1993 and 1994. Most worrisome to doctors and microbiologists at the hospital were the number of cases of purulent septic complications that did not respond to commonly prescribed antibiotics.

In 1995, the hospital infection control committee decided to search the reviews of randomly controlled trials available on CD-ROMs from the Cochrane Library to find out if the drug ceftriaxone would be appropriate for patients at the hospital. Because ceftriaxone had not been widely used at the hospital, doctors hoped that bacteria would be sensitive to it. But they wanted scientifically scrutinized evidence of the drug's efficacy before trying it.

Of seven studies reviewed in the Cochrane Library, all demonstrated that ceftriaxone was highly effective as a means of preventing infection. Based on the results of the search, the hospital went ahead with prescribing the medication--with very positive results. The number of infectious complications following surgery declined from 103 cases in 1996 to 32 in the first 11 months of 1997. The daily treatment cost has decreased from $39 per patient to $27 per patient, yielding a total annual decrease in pharmaceutical spending of about $100,000.

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