Do not perform peri-operative antibiotic prophylaxis when it is not necessary
The choice of administering peri-operative antibiotics depends on the type of surgery, the related infectious risk, and the patient’s underlying condition. The goal of proper peri-operative antibiotic prophylaxis is on the one hand to prevent morbidity and mortality related to surgical site infections (SSIs), and on the other hand to reduce misuse and inappropriate use of antibiotics so as to reduce adverse events from unnecessary drugs and the phenomenon of antibiotic resistance. Antimicrobial prophylaxis is recommended in all surgical procedures associated with a high rate of SSis (e.g., clean-contaminated or contaminated procedures) or where potential serious complications secondary to infection can be expected (e.g., in the implantation of prosthetic materials or other foreign devices). In surgeries considered clean, however, antibiotic prophylaxis does not reduce the possible occurrence of SSIs. The choice, therefore, to perform antibiotic prophylaxis and the decision of the appropriate molecule and doses must be carefully weighed in each individual case. Clinicians are advised to follow available guidelines.
1. Bianchini S, Rigotti E, Monaco S, et al. Surgical Antimicrobial Prophylaxis in Abdominal Surgery for Neonates and Paediatrics: A RAND/UCLA Appropriateness Method Consensus Study. Antibiotics 2022; Epub Feb 21. https://www.mdpi.com/2079-6382/11/2/279
2. Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect (Larchmt). 2013;14:73-156.
3. Tarchini G, Liau KH, Solomkin JS. Antimicrobial Stewardship in Surgery: Challenges and Opportunities. Clin Infect Dis. 2017;64(Suppl_2):S112-S114.
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.