Antibiotic Prophylaxis

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Does anyone knows if exist articles that provide antibiotic prophylaxis before a surgery (in healthy patients) modify infections post surgery?

PD: I´m spanish and i dont understand very well the technical words, please be clear.

THANKS

 

Hello Mushu

Welcome. You write in English better than I in Spanish!

The British National Formulary has a section on prophylactic antibiosis. I am sure that there is a Spanish formulary? If not, you should find the BNF on the web.

All the best

Bill

 

http://www.acfas.org/pubresearch/sam/june-2005/sam-proph.htm

 

W J Liggins and drsarbes thank you, the information is very interesting for me, thank you again

 

I've read the guidelines (as well as the CDC, IHI, ECRI, AORN and JCAHO guidelines) but none of them ever seem to address the special considerations (if any) of DIABETIC patients having ELECTIVE surgery.

What are the standards for this patient group, and do they differ for healthy Type II diabetics (not overweight; blood sugar well-controlled with diet, exercise, and insulin and or oral hypoglycemics) as opposed to brittle, morbidly obese diabetics with neuropathy and/or peripheral vascular disease?

I am thinking, specifically, of what the CDC and JCAHO would classify as "clean" procedures---i.e., single hammertoe arthroplasty, with or without K-wire (not diabetic foot ulcers.)

Do these patients need pre-op antibiotics or not? I can't get a consensus (though I know what is done in practice in my part of the country---central and Northern CA---EVERY podiatry patient gets a gram of Ancef pre-op (really, every orthopedic patient does, too--not just the total joint patients, or those with fractures of the long bones, or trauma patients.)

It seems to me that, since diabetics are known to be at higher risk for infections--not just SSIs; but any infections---that pre-op antibiotic prophylaxis should be standard of care. It also seems to me that diabetics (whether brittle or with good glycemic control) are at further risk for an SSI when there is a pin tract (such as with K-wire fixation.) However, the literature does not seem to agree with what's actually done in practice. Everything I see in the literature is geared toward the specific needs of diabetics who are ALREADY infected or presumed infected--such as those with diabetic ulcers or Charcot foot.

Am curious to hear what the practices are among other clinicians. (I am not a podiatrist, but an operating room nurse and foot care nurse.)

Thank you!