Surgical Antibiotic Prophylaxis: A Proposal for a Global Evidence-Based Bundle
Issued Date
2024-01-01
Resource Type
eISSN
20796382
Scopus ID
2-s2.0-85183107052
Journal Title
Antibiotics
Volume
13
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Antibiotics Vol.13 No.1 (2024)
Suggested Citation
Sartelli M., Coccolini F., Labricciosa F.M., Al Omari A.K.H., Bains L., Baraket O., Catarci M., Cui Y., Ferreres A.R., Gkiokas G., Gomes C.A., Hodonou A.M., Isik A., Litvin A., Lohsiriwat V., Kotecha V., Khokha V., Kryvoruchko I.A., Machain G.M., O’Connor D.B., Olaoye I., Al-Omari J.A.K., Pasculli A., Petrone P., Rickard J., Sall I., Sawyer R.G., Téllez-Almenares O., Catena F., Siquini W. Surgical Antibiotic Prophylaxis: A Proposal for a Global Evidence-Based Bundle. Antibiotics Vol.13 No.1 (2024). doi:10.3390/antibiotics13010100 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/95964
Title
Surgical Antibiotic Prophylaxis: A Proposal for a Global Evidence-Based Bundle
Author(s)
Sartelli M.
Coccolini F.
Labricciosa F.M.
Al Omari A.K.H.
Bains L.
Baraket O.
Catarci M.
Cui Y.
Ferreres A.R.
Gkiokas G.
Gomes C.A.
Hodonou A.M.
Isik A.
Litvin A.
Lohsiriwat V.
Kotecha V.
Khokha V.
Kryvoruchko I.A.
Machain G.M.
O’Connor D.B.
Olaoye I.
Al-Omari J.A.K.
Pasculli A.
Petrone P.
Rickard J.
Sall I.
Sawyer R.G.
Téllez-Almenares O.
Catena F.
Siquini W.
Coccolini F.
Labricciosa F.M.
Al Omari A.K.H.
Bains L.
Baraket O.
Catarci M.
Cui Y.
Ferreres A.R.
Gkiokas G.
Gomes C.A.
Hodonou A.M.
Isik A.
Litvin A.
Lohsiriwat V.
Kotecha V.
Khokha V.
Kryvoruchko I.A.
Machain G.M.
O’Connor D.B.
Olaoye I.
Al-Omari J.A.K.
Pasculli A.
Petrone P.
Rickard J.
Sall I.
Sawyer R.G.
Téllez-Almenares O.
Catena F.
Siquini W.
Author's Affiliation
Université de Parakou
School of Medicine, Trinity College Dublin
Faculty of Medicine Jordan University of Science and Technology
Siriraj Hospital
NYU Grossman Long Island School of Medicine
Western Michigan University Homer Stryker M.D. School of Medicine
Gomel State Medical University
Istanbul Medeniyet University
Azienda Ospedaliero Universitaria Pisana
Ospedale Sandro Pertini
Universidad Nacional de Asuncion
Catholic University of Health and Allied Sciences
School of Medicine
Al-Balqa Applied University
University of Minnesota Twin Cities
Università degli studi di Bari Aldo Moro
Ospedale M. Bufalini
Tianjin Medical University
University of Ilorin
Maulana Azad Medical College
Kharkiv National Medical University
Universidad de Buenos Aires
University of Medical Sciences of Santiago de Cuba
Global Alliance for Infections in Surgery
Military Teaching Hospital
Hospital Universitário Terezinha de Jesus
Podhalanski Specialized Hospital
Bizerte Hospital
Macerata Hospital
School of Medicine, Trinity College Dublin
Faculty of Medicine Jordan University of Science and Technology
Siriraj Hospital
NYU Grossman Long Island School of Medicine
Western Michigan University Homer Stryker M.D. School of Medicine
Gomel State Medical University
Istanbul Medeniyet University
Azienda Ospedaliero Universitaria Pisana
Ospedale Sandro Pertini
Universidad Nacional de Asuncion
Catholic University of Health and Allied Sciences
School of Medicine
Al-Balqa Applied University
University of Minnesota Twin Cities
Università degli studi di Bari Aldo Moro
Ospedale M. Bufalini
Tianjin Medical University
University of Ilorin
Maulana Azad Medical College
Kharkiv National Medical University
Universidad de Buenos Aires
University of Medical Sciences of Santiago de Cuba
Global Alliance for Infections in Surgery
Military Teaching Hospital
Hospital Universitário Terezinha de Jesus
Podhalanski Specialized Hospital
Bizerte Hospital
Macerata Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
In the multimodal strategy context, to implement healthcare-associated infection prevention, bundles are one of the most commonly used methods to adapt guidelines in the local context and transfer best practices into routine clinical care. One of the most important measures to prevent surgical site infections is surgical antibiotic prophylaxis (SAP). This narrative review aims to present a bundle for the correct SAP administration and evaluate the evidence supporting it. Surgical site infection (SSI) prevention guidelines published by the WHO, CDC, NICE, and SHEA/IDSA/APIC/AHA, and the clinical practice guidelines for SAP by ASHP/IDSA/SIS/SHEA, were reviewed. Subsequently, comprehensive searches were also conducted using the PubMed®/MEDLINE and Google Scholar databases, in order to identify further supporting evidence-based documentation. The bundle includes five different measures that may affect proper SAP administration. The measures included may be easily implemented in all hospitals worldwide and are based on minimal drug pharmacokinetics and pharmacodynamics knowledge, which all surgeons should know. Antibiotics for SAP should be prescribed for surgical procedures at high risk for SSIs, such as clean–contaminated and contaminated surgical procedures or for clean surgical procedures where SSIs, even if unlikely, may have devastating consequences, such as in procedures with prosthetic implants. SAP should generally be administered within 60 min before the surgical incision for most antibiotics (including cefazolin). SAP redosing is indicated for surgical procedures exceeding two antibiotic half-lives or for procedures significantly associated with blood loss. In principle, SAP should be discontinued after the surgical procedure. Hospital-based antimicrobial stewardship programmes can optimise the treatment of infections and reduce adverse events associated with antibiotics. In the context of a collaborative and interdisciplinary approach, it is essential to encourage an institutional safety culture in which surgeons are persuaded, rather than compelled, to respect antibiotic prescribing practices. In that context, the proposed bundle contains a set of evidence-based interventions for SAP administration. It is easy to apply, promotes collaboration, and includes measures that can be adequately followed and evaluated in all hospitals worldwide.