prophylactic antibiotics in surgery

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prophylactic antibiotics in surgery prophylactic antibiotics in surgery clint francis hs infection of incised skin or soft tissues is a common but potentially avoidable complication following a surgical procedure. antibiotic prophylaxis is an adjunct to good surgical technique reduce incidence of surgical site infection. causes minimal change to patient’s host defences. minimise adverse effects minimise the effect of antibiotics to patients normal flora goals 3 risk factors type of surgical wound insertion of prosthetic implants duration of surgery comorbidities type of surgery type def infection rate clean no viscus opened 1-2 clean contaminated viscus opened minimal spillage <10 contaminated open viscus with spillage or inflammatory disease 15-20 dirty pus/perforation /incision through an abscess <40 implants increases the risk of surgical site infection inoculum host defences comorbidities malnutrition metabolic diseases immunosupression(cancer hiv infection, steroids) indications highly recommended- prophylaxis unequivocally reduces major morbidities. recommended- prophylaxis reduces short term morbidity not recommended- prophylaxis …

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ration is affected by rate of absorption dosage the single dose of antibiotic used prophylactically is same as that of therapeutic use. type of surgery organisms encountered suggested regimen vascular s. epidermidis s. aureus aerobic gram negative bacilli three doses of flucoxacillin with or without gentamycin, vancomycin or rifampicin orthopaedic s. epidermidis s. aureus 1-3doses of broad spectrum cephalosporin oesophagogastric enterobacteriacea enterococci 1-3 doses of 2nd generation cephalosporin biliary enterobacteriacea enterococci 1 dose of 2nd generation cephalosporin small bowel enterobacteriacea anaerobes 1-3dosesof 2nd gen cephalosporin with or without metronidazole appendix/colorectal enterobacteriacea anaerobes 3 doses of 2nd gen cephalosporin with metronidazole penicillin – iv benzylpencillin - effective against gram-positive pathogens(streptococci, clostridia, staphylococci that doesn’t produce beta lactamase flucoxacillin – beta lactamase resistant penicillin – community acquired staphylococcal infection ampicillin and amoxicillin – beta lactamase penicillin cephalosporin – cefuroxime and cefotaxime are effective in intraabdominal infections and soft tissue infections. ceftazidime is …

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rity of consequences of ssi effectiveness of prophylaxis consequences of prophylaxis avoiding surgical site infection staff should wash their hands between patients. length of patient stay should be kept to minimum antiseptic skin preparation should be standardised. attention to theatre techniques and discipline avoid hypothermia perioperatively and ensure supplemental oxygenation in recovery thank you image2.jpeg image3.jpeg image4.jpeg image1.jpeg

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prophylactic antibiotics in surgery prophylactic antibiotics in surgery clint francis hs infection of incised skin or soft tissues is a common but potentially avoidable complication following a surgical procedure. antibiotic prophylaxis is an adjunct to good surgical technique reduce incidence of surgical site infection. causes minimal change to patient’s host defences. minimise adverse effects minimise the effect of antibiotics to patients normal flora goals 3 risk factors type of surgical wound insertion of prosthetic implants duration of surgery comorbidities type of surgery type def infection rate clean no viscus opened 1-2 clean contaminated viscus opened minimal spillage <10 contaminated open viscus with spillage or inflammatory disease 15-20 dirty pus/perforation /incision through a...

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