Antibiotic prophylaxis in surgery. (SIGN Guideline No 104)

contents
1 introduction ..................................................................................................................... 1
1.1 The need for a guideline.................................................................................................... 1
1.2 Remit of the guideline ....................................................................................................... 1
1.3 Definitions ........................................................................................................................ 3
1.4 Statement of intent ............................................................................................................ 3
2 Key recommendations ...................................................................................................... 4
2.1 Benefits and risks of antibiotic prophylaxis ........................................................................ 4
2.2 Administration of prophylactic antibiotics ......................................................................... 4
2.3 Implementing the guideline ............................................................................................... 5
3 risk factors for surgical site infection ............................................................................... 6
3.1 Factors affecting the incidence of surgical site infection ..................................................... 6
3.2 Probability of surgical site infection ................................................................................... 8
4 benefits and risks of antibiotic prophylaxis ...................................................................... 9
4.1 Benefits of prophylaxis ...................................................................................................... 9
4.2 Risks of prophylaxis........................................................................................................... 9
5 indications for surgical antibiotic prophylaxis .................................................................. 13
5.1 Introduction ...................................................................................................................... 13
5.2 Recommended indications for surgical antibiotic prophylaxis to prevent SSI ..................... 14
5.3 Recommended indications for surgical antibiotic prophylaxis to prevent SSI in children .... 24
5.4 Antibiotic prophylaxis to prevent chest or urinary tract infection ....................................... 28
6 Administration of prophylactic antibiotics ....................................................................... 29
6.1 Choice of antibiotic ........................................................................................................... 29
6.2 Timing of administration ................................................................................................... 30
6.3 Dosage selection ............................................................................................................... 31
6.4 Duration of prophylaxis ..................................................................................................... 31
6.5 Route of administration ..................................................................................................... 32
7 provision of information ................................................................................................... 35
7.1 Providing information and support .................................................................................... 35
7.2 Healthcare associated infection ......................................................................................... 35
7.3 Surgical site infection ........................................................................................................ 35
7.4 Sources of further information ........................................................................................... 36
contents