Antibiotic prophylaxis in surgery. (SIGN Guideline No 104)
Antibiotic prophylaxis in surgery. (SIGN Guideline No 104)
Antibiotic prophylaxis in surgery. (SIGN Guideline No 104)
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<strong>Antibiotic</strong> prophylAxis <strong>in</strong> <strong>surgery</strong><br />
20<br />
Operation Recommendation Odds Ratio NNT Outcome Evidence level<br />
AbDomen<br />
4 111<br />
<strong>Antibiotic</strong> <strong>prophylaxis</strong> should be considered <strong>in</strong> high<br />
risk* patients<br />
D<br />
therapeutic endoscopic<br />
procedures (endoscopic<br />
retrograde cholangiopancreatography<br />
and<br />
percutaneous endoscopic<br />
gastrostomy)<br />
*High risk: pancreatic pseudocyst, immunosupression, <strong>in</strong>complete biliary dra<strong>in</strong>age (eg primary<br />
scleros<strong>in</strong>g cholangitis or cholangiocarc<strong>in</strong>oma)<br />
spleen<br />
; <strong>Antibiotic</strong> <strong>prophylaxis</strong> is not recommended Post-splenectomy <strong>prophylaxis</strong> is covered<br />
elsewhere 112<br />
risk* patients<br />
; <strong>Antibiotic</strong> <strong>prophylaxis</strong> should be considered <strong>in</strong> high<br />
splenectomy<br />
*High risk: immunosuppression<br />
gynaecological<br />
Abdom<strong>in</strong>al hysterectomy A <strong>Antibiotic</strong> <strong>prophylaxis</strong> is recommended 1 ++113,114<br />
+115, 116<br />
Vag<strong>in</strong>al hysterectomy A <strong>Antibiotic</strong> <strong>prophylaxis</strong> is recommended 0.17 4 Pelvic <strong>in</strong>fection 1<br />
caesarean section A <strong>Antibiotic</strong> <strong>prophylaxis</strong> is highly recommended 0.41 19 Wound <strong>in</strong>fection 1 ++117<br />
Assisted delivery A <strong>Antibiotic</strong> <strong>prophylaxis</strong> is not recommended 1 ++118<br />
Wound <strong>in</strong>fection 4 119<br />
<strong>Antibiotic</strong> <strong>prophylaxis</strong> is recommended for third/fourth<br />
degree per<strong>in</strong>eal tears <strong>in</strong>volv<strong>in</strong>g the anal sph<strong>in</strong>cter/rectal<br />
mucosa<br />
per<strong>in</strong>eal tear D
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