REGULATED PREOPERATORY ANTIBIOTIC-PROPHYL AXIS

Prevent post-operative infection: Pathogenic bacteria inevitably devel op at the surgical site. The role of general hygiene measures and surg ical asepsia is to limit the contamination to a minimum. Antibiotic pr ophylaxis has the same aim of reducing the risk of post-operative infe ction, with the precise objective of minimising the consequences of ba cterial colonization by preventing trhe proliferation of germs suscept ible of producing septic complications. The efficacy of antibiotic pro phylaxis has been proven for numerous surgical procedures. Regulated p rescription: Antibiotic regimens have been established on the basis of a large body of work on the topic The prophylaxis protocol should use an antibiotic adapted to both the target bacteria and the surgical pr ocedure in order to achieve effective tissue concentrations at the pot ential site of infection. The antibiotics should be started during the 30 minutes prior to surgery so the antibiotic will be present at the site before contamination. Efficacious tissue concentrations must be m aintained throughout the duration of the operation, including closure. For long procedures, long half-life antibiotics or peroperative injec tions are used. Duration of prophylaxis: Antibiotics should be given f or as short a period as possible in order to avoid the risk oi selecti ng resistant strains. A unique preoperative injection has been proven to be effective in several surgical specialities. A 24-hour regimen ca n be prescribed, but prophylaxis should never exceed 48 hours. There i s no exception to this rule. Cost effectiveness: Clinicans should opt for the most economic antibiotic with equivalent efficacy.