Antibiotic prophylaxis in surgery: Summary of a Swedish-Norwegian consensus conference

This consensus document sets out proposals for antibiotic prophylaxis in ab dominal, urological, gynaecological, orthopaedic, vascular and thoracic sur gery. As far as possible the recommendations are based on prospective contr olled trials. However, for some procedures, e.g. lung surgery and implantat ion of pacemakers, documentation is lacking but antibiotic prophylaxis is g iven traditionally. The choice of antibiotics is generally conservative, em phasizing that antibiotics used for therapy should be avoided in prophylact ic regimens. Most recommendations are for the use of a first- or second-gen eration cephalosporin or an isoxazolyl penicillin, when necessary, combined with a nitroimidazole derivative (metronidazole or tinidazole). Suggestion s are given for more frequent use of orally administered antibiotics, such as co-trimoxazole, doxycycline, metronidazole or tinidazole. Emphasis is pu t on short-term prophylaxis. In most cases surgical antibiotic prophylaxis should be gi, en as a single dose and in no case should the prophylaxis tim e exceed 21 h.