Antibiotic prophylaxis in clean surgical cases and the role of community surveillance.
In an ongoing prospective study of clean surgical procedures, patients have been examined by specialist research nurses on a minimum of three occasions during the postoperative period to determine the incidence of wound complications. Whereas a previous retrospective audit suggested a wound infection rate of 2%, this community surveillance programme revealed the true rate as at least fourfold greater (p less than 0.001). Of these complications, more than 70% were detected only by the surveillance programme. Immediate benefit was obtained by a reduction in all complications. Despite these improvements, a core of postoperative sepsis remained, particularly in high-risk cases. Thus, a prospective, controlled, prophylactic antibiotic trial has been undertaken, in an attempt to reduce the infection rate still further. An antibiotic regimen of teicoplanin, 400 mg i.v., given as a single dose, was chosen because of the excellent activity of this agent against staphylococci and streptococci, and also because of the long half-life which renders it suitable for single-dose administration.
Karran
S J
SJ
University Surgical Unit, Southampton General Hospital, UK.
Karran
S E
SE
Toyn
K
K
Brough
P
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006020:Glycopeptides / Q000627:therapeutic use; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D011159:Population Surveillance; D011292:Premedication; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000517:prevention & control*; D017334:Teicoplanin
D000900:Anti-Bacterial Agents; D006020:Glycopeptides; D017334:Teicoplanin