Antibiotic prophylaxis in biliary tract surgery--current practice in The Netherlands.

A questionnaire about the current practice of antibiotic prophylaxis in biliary tract surgery was sent to the chairmen of the departments of surgery of 175 hospitals in The Netherlands. The Dutch hospitals are classified into three categories depending on the type of residency in general surgery. Overall, 80 per cent replied. Antibiotic prophylaxis in elective cholecystectomy is given in 76 per cent of the clinics (100/132), and single-dose prophylaxis is employed in 28 per cent of the clinics (28/100). In patients with acute cholecystitis, emergency surgery is the treatment of choice in 108 hospitals (82%). Differences in antibiotic prophylaxis between the three categories of hospitals include the omission of prophylaxis in elective cholecystectomy in 31 per cent of the C-clinics (vs. 10% in A-clinics and 16% in B-clinics), and the use of single-dose prophylaxis in 13 per cent of the B-clinics (vs. 30% of the A-clinics and 31% of the C-clinics). Since prophylaxis for more than 24 hours has no additional effect and peri-operative prophylaxis in acute cholecystitis is mandatory, antibiotic prophylaxis in biliary tract surgery is inappropriate in at least 31 hospitals in The Netherlands (23%).