Guidelines
General Principles

General Principles

General Principles of Antimicrobial Prophylaxis

  • Antimicrobial prophylaxis should be provided for surgical procedures for which it has been demonstrated to be beneficial
  • It is estimated that 50% of surgical site infections are preventable by application of evidence-based strategies

Antimicrobial surgical prophylaxis is administered to achieve serum and tissue antibiotic concentrations that exceed the minimum inhibitory concentration of the majority of organisms likely to be encountered, at the time of the incision and for the duration of the procedure. Key to achieving this goal is:

  • appropriate dosing
  • timely administration of first dose antimicrobial within 60 to 120 minutes of surgical incision
  • repeat dosing for prolonged procedures or in the event of major blood loss

General patient-related risk factors for surgical site infection include:

  • Extremes of age
  • Compromised nutritional status
  • Obesity
  • Diabetes mellitus
  • Tobacco use
  • Co-existent remote body site infection
  • Altered immune response
  • Corticosteroid therapy
  • Recent surgical procedure
  • Length of preoperative hospitalization
  • Colonization with microorganisms