SURGICAL ANTIBIOTIC PROPHYLAXIS

This is the pre-operative administration of antibiotics to reduce the risk of surgical site infection.

General principles

  • The need of prophylaxis depends on the nature of the expected wound
    • Wounds that are expected to be clean (no inflammation, and respiratory, genital, urinary and alimentary tract not entered) generally DO NOT require prophylaxis except where the consequences of surgical site infection could be severe (e.g. joint replacements)
    • Prophylaxis is indicated in cases of clean-contaminated wounds (entering respiratory, genital, urinary and alimentary tracts but no unusual contamination)
    • Treatment with a course of antibiotics is indicated in procedures with contaminated wounds (fresh open
      accidental wounds, operations with major breaks in sterile techniques), dirty or infected wounds (old traumatic wounds with retained necrotic tissue, clinical infection, perforated viscera)
  • Prophylaxis is given <60 minutes before the first incision
  • Refer to institution-specific protocols for details

Prophylaxis is not recommended for most uncomplicated clean procedures
One single dose prior to the procedure is usually sufficient Routine post-operative antimicrobial administration is
NOT recommended for most surgeries as it causes wastage of limited resources, causes unnecessary side effects to the patient and can lead to antimicrobial resistance.