Aim: To measure compliance with hospital guidelines for surgical antibiotic prophylaxis and estimate the impact on drug costs. Method: The impact of the guidelines introduced in January 1994 was evaluated in all patients undergoing operations during a 7-day period in June 1994 compared with all patients who had operations during a 7-day period in June 1993. The drug costs incurred by non-guideline prescribing were calculated. Results: The proportion of operations using prophylactic antibiotics increased significantly from 34% (55 of 160 operations) in 1993, to 55% (83 of 151 operations) in 1994 (p < 0.001). Despite the increase in antibiotic use, there was a decrease in overall expenditure on antibiotic prophylaxis from $6575 to $5760 for the periods in 1993 and 1994 respectively. A significant improvement in compliance with guideline recommendations for drug choice (p < 0.05) was observed, particularly a reduction in the non-guideline use of ceftriaxone.

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