Antibiotic Prophylaxis

Niña Patricia V. Orbe

Harold S. Talaue

MINOR SURGERY
L-NU FQDMF
College of Medicine
 Outline
I. Definition
II. Principles
III. Indications
IV. Administration of antibiotic prophylaxis
A. Choice of antibiotic
B. Timing
C. Duration
D. Route
V. Risks
I. DEFINITION
Antibiotic prophylaxis
• Prevention of infection using antimicrobial
therapy
• Given prior to surgical procedures

AHSP Report-Clinical Practice

Guidelines for Antimicrobial
Prophylaxis in Surgery
II. PRINCIPLES
• 1. Prevent surgical-site infections (SSIs)
• 2. Prevent SSI-related morbidity and mortality
• 3. Reduce the duration and cost of health care
• 4. Produce no adverse effects
• 5. Have no adverse consequences for the
microbial flora of the patient and the hospital

AHSP Report-Clinical Practice

Guidelines for Antimicrobial
Prophylaxis in Surgery
Antimicrobial agent should be:
1. Active against the pathogens
2. Given in an appropriate dosage and time
3. Safe
4. Administered for the shortest effective period

AHSP Report-Clinical Practice

Guidelines for Antimicrobial
Prophylaxis in Surgery
III. INDICATIONS
• Class I – Clean wounds and prosthetic devices
• Class II – Clean contaminated wounds
• Class III – Contaminated wounds
• Class IV – Dirty wounds

Principles of Surgery by
Schwartz 10th edition
Principles of Surgery by
Schwartz 10th edition
IV. ADMINISTRATION
A. CHOICE OF ANTIBIOTIC
1. Expected pathogens for that operative site
2. Local resistance patterns
3. Narrow spectrum, less expensive – 1st choice

Scottish Intercollegiate
Guidelines Network-Antibiotic
prophylaxis in surgery
• Antibiotic agents used:
-Penicillins
-Cephalosphorins
-Ampicillin – Sulbactam
-Vancomycin

Scottish Intercollegiate
Guidelines Network-Antibiotic
prophylaxis in surgery
Principles of Surgery by
Schwartz 10th edition
B. TIMING OF ADMINISTRATION
1. Intravenous – 60 minutes before incision
2. Vancomycin – IV infusion 90 minutes

Scottish Intercollegiate
Guidelines Network-Antibiotic
prophylaxis in surgery
C. DURATION OF PROPHYLAXIS
1. Single dose of antibiotic with a long enough
half-life
2. 24 hours for arthroplasty

Scottish Intercollegiate
Guidelines Network-Antibiotic
prophylaxis in surgery
• Additional dosage during the operation:
1. Cardiac surgery longer than 4 hours
2. For longer surgery or shorter-acting agents
3. In the event of major intraoperative blood
loss:
-Adults (>1,500ml)
-Children (25ml/kg)

Scottish Intercollegiate
Guidelines Network-Antibiotic
prophylaxis in surgery
D. ROUTE OF ADMINISTRATION
-Prophylactic antibiotics for surgical procedures
should be administered intravenously.
-Oral
-Topical

Scottish Intercollegiate
Guidelines Network-Antibiotic
prophylaxis in surgery
Other routes:

Scottish Intercollegiate
Guidelines Network-Antibiotic
prophylaxis in surgery
V. RISKS
1. Penicillin allergy
2. Anaphylaxis
3. Antibiotic-associated diarrhea
4. Clostridium difficile infection
5. Antibiotic resistance
6. Multiresistance carriage

Scottish Intercollegiate
Guidelines Network-Antibiotic
prophylaxis in surgery
Thank you for listening!