Surgical antibiotic prophylaxis: is the clinical practice based on evidence?

One method to avoid surgical site infection (SSI) is surgical antibiotic prophylaxis, which has been shown to be effective in the scientific literature. However, the benefit is obtained only when the following criteria are used correctly: pre-surgical administration; adequate antimicrobial selection based on the surgical procedure and the pathogen most frequently observed in SSI; administration of more than one dose in procedures of longer duration; and discontinuing the dose after surgical wound closure. This descriptive study was performed at a 706-bed tertiary care teaching hospital in the state of São Paulo, Brazil. 7,287 inpatients received 90,475 antimicrobial prescriptions. Of these, 71.1% were prescribed prophylactic prescriptions. Cefazolin was the most commonly used. Of particular note was the high utilisation of antimicrobial drugs, including aminoglycosides, in the orthopedics ward. In addition, the otolaryngology and head and neck surgery had a high rate of prescriptions of many antimicrobial classes. Authors concluded that surgical antibiotic prophylaxis utilisation is inappropriate and does not consider World Health Organization guidelines or hospital protocols. More details by the link.