Never administer antibiotics for perioperative prophylaxis beyond 24 hours after surgery. Antibiotic prophylaxis should be limited to the perioperative period. The choice to continue prophylaxis beyond the first 24 postoperative hours is not justified.

Type of practice

Drugs

Perioperative Antibiotic Prophylaxis (PAP) is an effective measure for the prevention of Surgical Site Infections (SSI), where indicated. However, its inappropriate use contributes significantly to total antibiotic consumption in hospitals and has been associated with increases in antimicrobial resistance (AMR) and health care costs. The World Health Organization (WHO) recommends not prolonging PAP beyond the end of surgery to prevent SSI. It is generally not recommended to continue PAP beyond 24 hours after surgery. The importance of the appropriate PAP for the prevention of SSI has been confirmed by several epidemiological studies, including a systematic review of 21 meta-analyses, a recent technical report and a systematic review of the European Center for Disease Prevention and Control (ECDC).

Sources

1. European Centre for Disease Prevention and Control. Systematic review and evidence-based guidance on perioperative antibiotic prophylaxis. Stockholm: ECDC; 2013.
2. SNLG 17. Antibioticoprofilassi perioperatoria nell’adulto. Linee guida 2008, aggiornamento 2011. Disponibile su: http://www.snlg-iss.it/cms/files/LG_AntibioticoP_Unico_2008.pdf
3. World Health Organization. Antimicrobial Resistance Global Report on surveillance 2014. Disponibile su: http://www.who.int/drugresistance/documents/surveillancereport/en/.
4. World Health Organization. Global Guidelines for the Prevention of Surgical Site Infection, second edition. WHO 2018. Disponibile su: https://www.who.int/publications/i/item/global-guidelines-for-the-prevention-of-surgical-site-infection-2nd-ed
5. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017;152(8):784–791.
6. Global Alliance for Infections in Surgery. Principles of antibiotic prophylaxis in surgery. Disponibile su: https://infectionsinsurgery.files.wordpress.com/2019/02/prophylaxis-principles-1-1.pdf

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.