Antibiotic Prophylaxis for Abdominal Surgery: When to Recommend? Brazilian College of Digestive Surgery Position Paper

Abstract

Background: Surgical antibiotic prophylaxis is an essential component of perioperative care. The use of prophylactic regimens of antibiotics is a well-established practice that is encouraged to be implemented in preoperative/perioperative protocols in order to prevent surgical site infections. Aims: To emphasize the crucial aspects of antibiotic prophylaxis in abdominal surgery. Results: Antibiotic prophylaxis is defined as the administration of antibiotics before contamination occurs, given with the intention of preventing infection by achieving tissue levels of antibiotics above the minimum inhibitory concentration at the time of surgical incision. It is indicated for clean operations with prosthetic materials or in cases where severe consequences may arise in the event of an infection. It is also suitable for all clean-contaminated and contaminated operations. The spectrum of action is determined by the pathogens present at the surgical site. Ideally, a single intravenous bolus dose should be administered within 60 minutes before the surgical incision. An additional dose should be given in case of hemorrhage or prolonged surgery, according to the half-life of the drug. Factors such as the patient's weight, history of allergies, and the likelihood of colonization by resistant bacteria should be taken into account. Compliance with institutional protocols enhances the effectiveness of antibiotic use. Conclusions: Surgical antibiotic prophylaxis is associated with reduced rates of surgical site infection, hospital stay, and morbimortality.

Characteristics of patients associated with antibiotic use among gastrointestinal surgery at the Academic Hospital, Universitas Gadjah Mada

“…Surgical antibiotic prophylaxis is associated with reduced surgical site infection rates, hospital stay, and mortality. 11 Surgical antibiotic prophylaxis is a cornerstone of perioperative care. 11 The study shows that ceftriaxone from the cephalosporin group was the single prophylactic antibiotic most often used in digestive surgery.…”

“…11 Surgical antibiotic prophylaxis is a cornerstone of perioperative care. 11 The study shows that ceftriaxone from the cephalosporin group was the single prophylactic antibiotic most often used in digestive surgery. The antibiotic spectrum should be selected according to the local flora of the surgical site.…”

“…The antibiotic spectrum should be selected according to the local flora of the surgical site. 11 The most widely used antibiotics are first-and secondgeneration cephalosporin. 11 Based on a systematic review, it was also stated that those included in the top 15 antibiotics most commonly consumed in Indonesia are β-lactams, especially cephalosporin and penicillins.…”

“…11 The most widely used antibiotics are first-and secondgeneration cephalosporin. 11 Based on a systematic review, it was also stated that those included in the top 15 antibiotics most commonly consumed in Indonesia are β-lactams, especially cephalosporin and penicillins. 22 Bacterial culture was not usually performed on digestive surgery patients.…”

“…The antibiotic prophylaxis is a very brief course of antibiotics initiated closely before, 10 during and after the operative procedures to prevent infectious complications or surgical site infections, 11,12 while it was considered therapeutic when it was prescribed to treat existing disease. 12 However, using prophylactic antibiotics in clinical practice must follow the existing guide.…”