Perioperative antibiotic prophylaxis: a critical review.
BACKGROUND
The value of perioperative prophylaxis is established for clean-contaminated procedures. For clean surgery, prophylaxis traditionally has been reserved for prosthetic device implantation procedures.


METHODS
Review of pertinent English-language literature.
Evidence suggests that prophylactic antibiotics are advisable for at least some non-prosthetic procedures and that glycopeptides might have a role for major prosthetic surgery in units with a high prevalence of methicillin-resistant Staphylococcus aureus. In clean-contaminated surgery, cefazolin is recommended, although not for colorectal procedures or obstetric/gynecologic surgery that requires anti-anaerobic coverage.


CONCLUSIONS
Antibiotic prophylaxis is generally overprescribed (i.e., given for too long). Short-duration prophylaxis is effective and safe.
De Lalla
Fausto
F
Department of Infectious Diseases, Ospedale S. Bortolo, Vicenza, Italy. faustodelalla@alice.it
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000627:therapeutic use; D003428:Cross Infection / Q000517:prevention & control; D006020:Glycopeptides / Q000627:therapeutic use; D006801:Humans; D017053:Infection Control / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D006020:Glycopeptides; D002437:Cefazolin