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World Journal of Surgery

, Volume 6, Issue 3, pp 262–267 | Cite as

Principles of antimicrobial prophylaxis

  • Douglas W. Burdon
World Progress in Surgery

Abstract

The most important principle in surgical antibiotic prophylaxis is to ensure high blood levels of antibiotic at the time of anticipated wound contamination. This is best achieved by intravenous administration commenced at the time of induction of anesthesia. The continued efficacy of prophylaxis depends on the implementation of policies that minimize the opportunities for bacteria to acquire resistance to antibiotics. Prophylaxis should, therefore, be used judiciously and restricted to operations for which it is of established benefit. These are mainly operations in which a viscus colonized by bacteria is opened and in which bacterial contamination is unavoidable. Prophylaxis is also used for certain cardiovascular and orthopedic implant operations in which septic complications are a major threat to a successful outcome and to the life of the patient. The choice of antibiotic should be based on knowledge of the bacterial species likely to contaminate the wound and cause infection. The duration of prophylaxis should be short, and should not be extended beyond the minimum period known to be effective. Controlled trials have established that a single dose of antibiotic is sufficient for many operative procedures and that there is no benefit in prolonging prophylaxis beyond the period when the open wound is exposed to bacterial contamination.

Keywords

Intravenous Administration Bacterial Species Blood Level Successful Outcome Antibiotic Prophylaxis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Le principe fondamental de l'antibiothérapie prophylactique correspond à la nécessité d'obtenir la plus haute saturation possible du sang en antibiotiques au moment ou le risque de contamination est le plus grand. Pour ce faire il convient d'administrer l'antibiotique par voie intra-veineuse au moment de l'induction anesthésique. Pour que l'antibiothérapie prophylactique garde sa valeur il convient de réduire l'emploi excessif des antibiotiques qui ne peut conduire qu'à accentuer la résistance des germes. L'antibiothérapie prophylactique ne concerne donc que des cas bien définis ou elle est indispensable. Il en est ainsi des interventions exposées à la contamination microbienne lors de l'ouverture d'un viscère creux. Il en est de même des interventions cardiovasculaires et des interventions orthopédiques qui nécessitent l'emploi de matériel prothétique.

Le choix de l'antibiotique a employer repose sur la connaissance exacte des germes susceptibles de provoquer l'infection pour une intervention donnée.

L'antibiothérapie prophylactique doit être de courte durée. Elle ne doit pas dépasser le temps bien déterminé ou elle est efficace.

Des essais contrôlés ont permis d'établir qu'une seule dose d'antibiotiques est suffisante et qu'il n'est d'aucun intérêt de prolonger l'antibiothérapie au delà du temps de la contamination.

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Copyright information

© Société Internationale de Chirurgie 1982

Authors and Affiliations

  • Douglas W. Burdon
    • 1
  1. 1.Department of MicrobiologyThe General HospitalBirminghamUK

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