Antimicrobial prophylaxis in colorectal surgery

Clinical practice guidelines for antimicrobial prophylaxis in surgery

“…antimicrobial if an agent with a short half-life is used and the procedure duration exceeds the recommended redosing interval (starting from the time of initiation of the preoperative dose) and if intraoperative blood loss occurs. 6,41,120,418,444,445 No significant difference was seen in SSI rates with single-dose cefazolin, single-dose cefotetan, and cefazolin given as one preoperative dose and a second dose three hours later for procedures with a duration of less than three hours. 118 SSI rates were significantly higher with a single dose of cefazolin for procedures with a duration of greater than three hours.…”

“…[416][417][418] Other risk factors include extended procedure duration (e.g., >3.5 hours), 59 423,424 and obesity. 412,418 Organisms. The infecting organisms in colorectal procedures are derived from the bowel lumen, where there are high concentrations of organisms.…”

Meta-analysis on Surgical Infections

“…Of the remaining three meta-analyses (15.8%), one (5.3%) 22 focused on colorectal surgery, one (5.3%) 17 on antimicrobial prophylaxis after appendicectomy, and one (5.3%) 21 on prophylaxis for the prevention of infections in cirrhotic patients with gastrointestinal bleeding. All of them found antibiotic prophylaxis to be superior regarding wound infection rates.…”

Preoperative antibiotic prophylaxis practice and guideline adherence in Jordan: a multi-centre study in Jordanian hospitals

“…An Indian study reported that antibiotics were administered for as long as 14 days and only 1% to 8% of surgeons who prescribed antibiotics in surgical procedures stopped prophylaxis after 24 hours [16]. Extended prophylaxis has been shown to be of no benefit [2,11,17], and is potentially harmful [2,18] due to the development of drug toxicity, super-infections [2], and bacterial resistance [2,6].…”