Antimicrobial prophylaxis in surgery

Article Abstract:

Antibiotics, agents that prevent the growth of microorganisms, may be used to decrease the incidence of infection, particularly in wounds, after certain operations. However, these drugs may also cause toxic and allergic reactions, growth of bacteria resistant to antibiotics, and superinfection, a new infection due to an organism different from the one causing the original infection. Surgical antibiotic prophylaxis, or the use of antimicrobial medications to prevent infection after surgery, is not required for 'clean' or sterile surgery and operations involving body tissues with normally low levels of microorganisms, unless an external device is being implanted. The antibiotic is usually administered 30 minutes before surgery, and again during the procedure if the operation is prolonged or if there is massive blood loss. Antibiotic medication is not usually required after the operation. Prophylactic antibiotics have been useful in surgery involving the heart, blood vessels, bones and joints, eyes, head and neck, gastrointestinal tract, biliary tract, appendix, and genital organs. The surgical procedures associated with a low incidence of infection and those that do not benefit from prophylactic antibiotics are also described. The ideal antibiotic should be effective in reducing the number of bacteria below the level required to cause infection. Cefazolin is used in most procedures, including obstetrical and gynecological operations. Cefoxitin is preferred for colorectal surgery and appendectomy because it is more effective against bowel bacteria, including Bacteroides fragilis. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Antimicrobial prophylaxis in surgery

Article Abstract:

The preventive use of antimicrobial drugs for surgery should not be routine, but reserved for operations in which infection is critical. Those would be operations with a high rate of infection, installation of prosthetic implants, or those in which infection can be disastrous such as heart surgery. Use should be balanced against the possibility of allergic reactions, toxic side-effects, and the development of drug-resistant bacteria. When indicated, cefazolin is recommended in most instances, except for colorectal surgery, where cefoxitin or cefotetan is more effective against the type of anaerobic bacteria found in the bowels.

Infection, Antibacterial agents, Cefotetan, Cefoxitin, Cefazolin

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Antimicrobial prophylaxis in surgery

Article Abstract:

Several antibiotics can prevent infections following medical procedures with a high complication rate. These procedures include cardiothoracic surgery and the surgical placement of prosthetic devices. Researchers have found that a single dose of an anti-infective agent before the operation is usually enough. A second dose is given only if the patient loses a lot of blood or if the procedure is lengthy. Cefazolin is recommended for most procedures, but vancomycin should be used if methicillin-resistant staphylococci are present. In surgeries involving the colorectal area or the appendix, cefoxitin or cefotetan is recommended.

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