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Antimicrobial Prophylaxis in Surgery: General Concepts and Clinical Guidelines

Published online by Cambridge University Press:  02 January 2015

Claude Martin ,
French Study Group on Antimicrobial Prophylaxis in Surgery  and
French Society of Anesthesia and Intensive Care
Claude Martin*
Affiliation:
Department of Anesthesia and Intensive Care, Hôpital Nord, Marseilles University Hospital System, Marseilles School of Medicine, Marseilles, France
*
Service de Réanimation, Hôpital Nord, 13915 Marseille Cedex 20, France
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Abstract

Bacteria are found in 90% of surgical incisions, regardless of surgical technique or environment. Initially, the number of pathogens is low, but proliferation is facilitated by favorable local conditions and weakened host defense mechanisms. The principles of presurgical administration of antibiotics are well defined, but a few controversies persist. An ideal antimicrobial agent would not induce bacterial resistance in pathogenic organisms, would penetrate tissues effectively, would have a long enough half-life so that a single injection could guarantee protection throughout the operation, would have a low toxicity, would not interfere with anesthetics, would be easy to administer, and would be cost-effective.

Type
From the Third International Conference on the Prevention of Infection
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 7 , July 1994 , pp. 463 - 471
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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References

1. Altemeier, A, Burke, JF, Pruitt, BA, Sandusky, WR. Definitions and classitications of surgical infections. In: Altemeier, WA, ed. Manual on Control of Infection in Surgical patients, Vol. 1. Philadelphia, PA: JB Lippincott; 1993:19–30.Google Scholar
2. Culver, DH, Horan, TC, Gaynes, RP, Mar-tone, WJ, Jarvis, WR, Emori, TG. Surgical wound infection rates by wound class, operative procedure and patient risk index. Am J Med 1991;91(suppl):152S–157S.Google Scholar
3. Page, CP, Bohnen, JMA, Fletcher, JR, McManus, AT, Solomkin, JS, Wittman, DH. Antimicrobial prophylaxis for surgical wounds. Guidelines for clincal use. Arch Surg 1993;128:79–88.CrossRefGoogle Scholar
4. Widdison, AL, Pope, NRJ, Brown, EM. Survey of guidelines for antimicrobial prophylaxis in surgery J Hosp Infect 1993;25:199–205.Google Scholar
5. Gorbach, SL, Condon, RE, Conte, JE, Kaiser, AB, Ledger, WJ, Nichols, RL. General guidelines for the evaluation of new anti-infective drug for prophylaxis of surgical infections. Evaluation of new anti-infective drugs for surgical prophylaxis. Clin Infect Dis 1992;15(suppl 1)S313–S338.Google Scholar
6. Kernodle, DS, Barg, NL, Kaiser, AB. Low-level colonization of hospitalized patients with methicillin-resistant coagulase-negative staphylococci and emergence of the organisms during surgical antimicrobial prophylaxis. Antimicrob Agents Chemother 1988;32:202–208.Google Scholar
7. Kling, PA, Ostensson, R, Granstrom, S, Burman, LG. A 7-year survey of drug resistance in aerobic and anaerobic fecal bacteria of surgical inpatients: clinical relevance and relation to local antibiotic consumption. Scand J Infect Dis 1989;21/6:589–596.CrossRefGoogle ScholarPubMed
8. Gerding, DN, Hall, WH, Schierl, EA. Antibiotic concentrations in ascitic fluid of patients with ascites and bacterial peritonitis. Ann Intern Med 1977;86:708–713.CrossRefGoogle ScholarPubMed
9. Hall, WH, Gerding, DN, Schierl, EA. Penetration of tobramycin into infected extravascular fluids and its therapeutic effectiveness. J Infect Dis 1977;135,957–961.Google Scholar
10. Zak, O, Kradolfer, E Effects of subminimal inhibitory concentrations of antibiotics in experimental infections. Rev Infect Dis 1979;1:862–879.CrossRefGoogle ScholarPubMed
11. Polk, HC, Lopez-Major, JE Postoperative wound infection: a prospective study of determinant factors and prevention. Surgery 1969;66:97–103.Google Scholar
12. Pavan, MM, Malynk, DL. A cost effective approach to surgical antibiotic prophylaxis. Can J Hosp Pharm 1992;45:151–156.Google Scholar
13. Nord, CE. Surgical prophylaxis and treatment of surgical infections with quinolones. Rev Infect Dis 1989;11(suppl 5)S1287–S1241.Google Scholar
14. Wittman, DH. Antibiotic concentrations in tissue fluid during the vulnerable period as rationale basis for prophylaxis of postoperative infections: focus on infections after operations of the colon, biliary tree and bone. In: Ishigami, J ed. Recent Advances in Chemotherapy: Proceedings of the 14th International Congress of Chemotherapy, Kyoto, Japan, 1985. Tokyo, Japan: University of Tokyo Press; 1985: 189192.Google Scholar
15. Shapiro, M, Munoz, A, Tager, IB, et al. Risk factors for infection at the operative site after abdominal or vaginal hysterectomy. N Engl J Med 1982;307:1661–1666.Google Scholar
16. Clarke, JS, Condon, RE, Barlett, JG, et al. Preoperative oral antibiotics reduce septic complications of colon operations: results of prospective, randomized, double-blind clinical study. Ann Surg 1977;186:251–259.Google Scholar
17. Proud, G, Chamberlain, J. Antimicrobial prophylaxis in elective colonic surgery. Lancet 1979;2:1017–1018.CrossRefGoogle ScholarPubMed
18. Pitt, HA, Postier, RG, MacGowan, WAL, et al. Prophylactic antibiotics in vascular surgery. Topical, systemic or both? Ann Surg 1980:192:356–363.Google Scholar
19. Sutherland, RD, Martinez, HE, Guynes, WA, LaWayne Miller, O. Post-operative chest wound infections in patients requiring coronary by-pass. A controlled study evaluating prophylactic antibiotics. J Thor Cardiovasc Surg 1977;73:944–947.Google Scholar
20. Sutherland, RD. LaWayne Miller, O, Martinez, HE, Guynes, WA. Coronary arterial by-pass operations whithout antibiotic coverage. Chest 1979;76:174–175.Google Scholar
21. Burke, JE The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery 1961;50:161–168.Google ScholarPubMed
22. Stone, HH, Hooper, CA, Kolb, LD, et al. Antibiotics prophylaxis in gastric, biliary and colonic surgery. Ann Surg 1976;184:443–452.Google Scholar
23. Classen, DC, Evans, S, Pestotnik, SL, Horn, SD, Menlove, RL, Burke, JP. The timing of prophylactic administration of antibiotics and the risk of surgical wound infection. N Engl J Med 1992;326:281–286.CrossRefGoogle ScholarPubMed
24. Di Piro, JT, Bivins, BA, Reckord, KE, et al. The prophylactic use of antimicrobials in surgery. Clin Probl Surg 1983;20:69–132.CrossRefGoogle Scholar
25. Nichols, RL. Post-operative infections and antimicrobial prophylaxis. In: Mandell, GL, Douglas, RG, Bennet, JE, eds. Principles and Practice of Infections Diseases. NewYork, NY: John Wiley; 1985:1637–1644.Google Scholar
26. Martin, C, Bruguerolle, B. Mallet, MN, Condomines, M, Sastre, B, Gouin, F. Pharmacokinetics and tissue penetration of a single dose of ornidazole (1000 mg) for antibiotic prophylaxis in cola-rectal surgery. Antimicrob Agents Chemother 1990;34:1921–1924.Google Scholar
27. Di Piro, JT, Cheung, RPF, Bowden, TA, Mansberger, JA. Single dose systemic antibiotic prophylaxis of surgical wound infections. Am J Surg 1986;152:552–559.Google Scholar
28. Giersky, KE, Danielsen, S, Garbery, O, et al. A single dose tinidazole and doxicycline prophylaxis in elective surgery of colon and rectum. Ann Surg 1982;195:227–231.Google Scholar
29. Gonik, B. Single versus three dose cefotaxime prophylaxis for cesaman section. Obstet Gynecol 1985;65:189–193.Google Scholar
30. Hemsell, DL. Heard, ML, Nobles, BJ, Hemsell, PG. Single dose cefoxitin prophylaxis for premenopausal women undergoing vaginal hysterectomy. Obstet Gynecol 1984;63:285–290.Google Scholar
31. Higgins, AF, Lewis, A, Noone, P, Hole, ML. Single and multiple dose cotrimoxazole and metronidazole in colorectal surgery. Br J Surg 1980;67:90–92.Google Scholar
32. Cruse, PJE, Foord, R. The epidemiology of wound infections. A 10 year prospective study of 62,939 wounds. Surg Clin North Am 1980;60:27–40.Google Scholar