Antibiotic prophylaxis in surgery. (SIGN Guideline No 104)

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Antibiotic prophylAxis in surgery 52 S. boulardi Saccharomyces boulardi sign Scottish Intercollegiate Guidelines Network smc Scottish Medicines Consortium sshAip Scottish Surveillance of Healthcare Associated Infection Programme ssi surgical site infection uti urinary tract infection Vp ventriculoperitoneal Vre vancomycin-resistant enterococci
Annex 1 Key questions used to develop the guideline The guideline is based on a series of structured key questions that, where possible, define the population concerned, the intervention (or diagnostic test, etc) under investigation, the type of control used, and the outcomes used to measure the effectiveness of the interventions. These questions form the basis of the systematic literature search. the Key Questions useD to DeVelop the guiDeline RISK FACToRS FoR SuRGICAl SITE INFECTIoN Key question 1. What factors increase or decrease the risk of SSI in patients receiving antibiotic prophylaxis? Consider: comorbidities such as diabetes, high BMI, disabilities immunosupression infection of site smoking perioperative hypothermia hypo-oxygenation early goal directed therapy. BENEFITS AND RISKS oF ANTIBIoTIC PRoPHYlAxIS Key question 2. 3. 4. 5. 6. What is the likelihood that those people with a penicillin allergy are allergic to cephalosporins? What is the best definition of penicillin allergy? What is the evidence that administering antibiotic prophylaxis during surgery increases the risk of the following in the patient? anaphylaxis antibiotic-induced diarrhoea Clostridium difficile. What is the evidence that administering antibiotic prophylaxis during surgery increases antibiotic-resistant strains in the general population? What is the evidence that multiresistance carriage in patients undergoing surgical procedures increases the incidence of SSI? Is there evidence that changing the prophylactic antibiotic, when MRSA carriage is known, changes management of SSI? See guideline section 3 See guideline section 4.2.1 4.2.2-4.2.4 4.2.5 4.2.6 6.1.1 Annexes 53
Page 1 and 2:
SIGN Scottish Intercollegiate Guide
Page 3 and 4:
Scottish Intercollegiate Guidelines
Page 5 and 6:
contents 1 introduction ...........
Page 7 and 8: 1 introduction 1.1 the neeD for A g
Page 9 and 10: 1.3 Definitions Prophylactic antibi
Page 11 and 12: 2.3 implementing the guiDeline ; ;
Page 13 and 14: Table 2 ASA classification of physi
Page 15 and 16: 4 benefits and risks of antibiotic
Page 17 and 18: other symptomatologies show either
Page 19 and 20: 5 indications for surgical antibiot
Page 21 and 22: Operation Recommendation Odds Ratio
Page 35 and 36: 6 Administration of prophylactic an
Page 37 and 38: 6.3 DosAge selection It is generall
Page 39 and 40: Results from studies on the use of
Page 41 and 42: 7 provision of information 7.1 proV
Page 43 and 44: 7.4.2 INTERNATIoNAl oRGANISATIoNS c
Page 45 and 46: 8.2 possible cost-effectiVeness Dec
Page 47 and 48: 8.3 implementAtion Guideline implem
Page 49 and 50: In the uK, the national mandatory s
Page 51 and 52: facial surgery facial skin surgery,
Page 53 and 54: 10 Development of the guideline 10.
Page 55 and 56: 10.2.2 ACKNoWlEDGEMENTS SIGN would
Page 57: Abbreviations AAD antibiotic-associ
Page 61 and 62: 13. Is antibiotic prophylaxis recom
Page 63 and 64: ADMINISTRATIoN oF PRoPHYlACTIC ANTI
Page 65 and 66: Annex 2 (continued) organ/space ssi
Page 67 and 68: Annex 4 Table of common pathogens S
Page 69 and 70: Annex 6 Calculating the cost effect
Page 71 and 72: eferences 1. Scottish Intercollegia
Page 73 and 74: 93. Da Costa A, Kirkorian G, Cucher
Page 75 and 76: 173. Kampougeris G, Antoniadou A, K
Page 78: ISBN 978 1 905813 34 6 Scottish Int
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Antibiotic prophylaxis in surgery. (SIGN Guideline No 104)

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