Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery

Abstract

T hese guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA). This work represents an update to the previously published ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery [1], as well as guidelines from IDSA and SIS [2,3]. The guidelines are intended to provide practitioners with a standardized approach to the rational, safe, and effective use of antimicrobial agents for the prevention of surgical site infections (SSIs) based on currently available clinical evidence and emerging issues. Prophylaxis refers to the prevention of an infection and can be characterized as primary prophylaxis, secondary prophylaxis, or eradication. Primary prophylaxis refers to the prevention of an initial infection. Secondary prophylaxis refers to the prevention of recurrence or reactivation of a preexisting infection. Eradication refers to the elimination of a colonized organism to prevent the development of an infection. These guidelines focus on primary perioperative prophylaxis. Guidelines development and use Members of ASHP, IDSA, SIS, and SHEA were appointed to serve on an expert panel established to ensure the validity, reliability, and utility of the revised guidelines. The work of the panel was facilitated by faculty of the

Diminishing Surgical Site Infections in Australia: Time Trends in Infection Rates, Pathogens and Antimicrobial Resistance Using a Comprehensive Victorian Surveillance Program, 2002–2013

“…This approach is consistent with international consensus guidelines. 29 Risk-adjustment is necessary for reporting SSI surveillance data, 30 and we applied risk-indexing according to criteria established by the NHSN/CDC (Table 1). 17 These data confirm that crude SSI rates do not reliably reflect trends or enable interhospital comparison.…”

Propofol Sedation Exacerbates Kidney Pathology and Dissemination of Bacteria during Staphylococcus aureus Bloodstream Infections

“…Single-dose antibiotic prophylaxis is part of routine patient care prior to surgery or admission into the ICU (55,(74)(75)(76)(77). Studies have shown that administering antibiotic prophylaxis reduces postsurgical infections by up to 50% (78) and is similarly effective in reducing ICU-acquired infections (79).…”

“…Because the risk of hospital-acquired infection increases as a result of surgery or prolonged stay (such as in intensive care units), patients generally receive prophylactic doses of antibiotics prior to undergoing any procedure (50)(51)(52)(53). Vancomycin is a broad-spectrum antibiotic that is sometimes given as prophylaxis before surgery (54,55). To assess whether the administration of vancomycin could effectively reduce the pathologies observed in animals exposed to propofol and infected with MRSA, mice were treated with vehicle alone, propofol alone, or vehicle or propofol plus a prophylactic single intravenous dose of vancomycin 24 h prior to tail vein infection with MRSA.…”

Audit Secara Prospektif terhadap Antimicrobial Stewardship Program pada Pasien Kanker Payudara di RSUP Dr. M. Djamil Padang

“…Total pasien kanker payudara yang dilakukan kultur berjumlah 7 orang pasien, terdiri dari 3 orang pasien di [16,17,18].…”

“…Peresepan antibiotik profilaksis dilakukan secara empiris dan berdasarkan keahlian dokter penulis resep, dan menurut apoteker pemilihan antibiotik hanya merujuk kepada Formularium Nasional tahun 2016. Antibiotik yang digunakan sebagai antibiotik profilaksis operasi kanker payudara adalah sefazolin yang merupakan sefalosporin generasi I [16,29,31]. Sementara penggunaan antibiotik terbanyak pada pasien operasi kanker payudara adalah seftriakson sebesar 77,8% yang merupakan antibiotik golongan sefalosporin generasi III.…”