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Antibiotic prophylaxis refers to the prevention of ing to data on pharmacology, microbiology, clinical exinfection complications using antimicrobial therapy (most perience and economy. Drugs should be selected with a
commonly antibiotics).
reasonable spectrum of activity against pathogens likely
Even when sterile techniques are adhered to, surgical pro- to be encountered, and antibiotics should be chosen with
kinetics that will ensure adequate serum and tissue levels
cedures can introduce bacteria and other microbes in the
throughout
the risk period.
blood (causing bacteremia), which can colonize and infect dierent parts of the body. An estimated 5 to 10 percent of hospitalized patients undergoing otolaryngology
(head and neck) surgery acquire a nosocomial (hospital) infection, which adds a substantial cost and an average of 4 extra days to the hospital stay.
For prophylaxis in surgery, only antibiotics with good tolerability should be used. Cephalosporins remain the preferred drugs for perioperative prophylaxis due to their
low toxicity. Parenteral systemic antibiotics seem to be
more appropriate than oral or topical antibiotics because
the chosen antibiotics must reach high concentrations at
all sites of danger. It is well recognized that broadspectrum antibiotics are more likely to prevent gramnegative sepsis. New data demonstrate that third generation cephalosporins are more eective than rst and
second generation cephalosporins if all perioperative infectious complications are taken into consideration. Dermatologic surgeons commonly use antibiotic prophylaxis
to prevent bacterial endocarditis. Based on previous studies, though, the risk of endocarditis following cutaneous
surgery is low and thus the use of antibiotic prophylaxis
is controversial. Although this practice is appropriate for
high-risk patients when skin is contaminated, it is not recommended for noneroded, noninfected skin.[1]
Microbial infections
2.3
Long-acting, broad-spectrum antibiotics oer the following advantages by comparison to short-acting antimicrobials in perioperative prophylaxis:
A single dose covers the whole perioperative risk period - even if the operation is delayed or long-lasting
- and with regard to respiratory and urinary tract infections
Repeat administrations for prophylaxis are not necessary, so that additional doses are less likely to be
forgotten (an advantage of practical value in a busy
working situation such as a hospital)
Less risk of development of resistance and less side
eects
Increased compliance and reduced errors of administration
Possibly better-eectiveness (less material and labor
cost, less septic perioperative complications)
References
Resources
Antimicrobial Therapy in Otolaryngology Archived
11 December 2005 at the Wayback Machine
Guidelines for Antimicrobial Usage 2008-2009 Tables 29 - 31 from the Cleveland Clinic
Antimicrobial prophylaxis Virginia-Maryland Regional College of Veterinary Medicine
Disease Management Project Online Medical Reference from the Cleveland Clinic
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