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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ADMINISTRATIoN oF PRoPHYlACTIC ANTIBIoTICS<br />
Key question<br />
23. In patients undergo<strong>in</strong>g surgical procedures which of the follow<strong>in</strong>g<br />
antibiotics are most effective at prevent<strong>in</strong>g surgical site <strong>in</strong>fection?<br />
Consider:<br />
β-lactam, qu<strong>in</strong>olones, cephalaspor<strong>in</strong>s, glycopeptides<br />
MRSA carriage.<br />
24. What is the optimum time to adm<strong>in</strong>ister prophylactic antibiotics to<br />
prevent SSI?<br />
25. In patients undergo<strong>in</strong>g surgical procedures are multiple or s<strong>in</strong>gle doses of<br />
antibiotics more effective at prevent<strong>in</strong>g surgical site <strong>in</strong>fection?<br />
26. What is the evidence that patients undergo<strong>in</strong>g surgical procedures <strong>in</strong><br />
excess of two hours require an additional dose of antibiotic to prevent<br />
surgical site <strong>in</strong>fection?<br />
Consider:<br />
half-life of antibiotic<br />
fluid/blood loss.<br />
27. In patients undergo<strong>in</strong>g surgical procedures and receiv<strong>in</strong>g antibiotic<br />
<strong>prophylaxis</strong> which of the follow<strong>in</strong>g routes is most effective at prevent<strong>in</strong>g<br />
surgical site <strong>in</strong>fection?<br />
Consider:<br />
Iv<br />
oral<br />
topical (bone cement, mesh, grafts, eardrops)<br />
rectal<br />
<strong>in</strong>traperitoneal washout.<br />
IMPlEMENTING THE GuIDElINE<br />
Key question<br />
28. What strategies exist to <strong>in</strong>crease the effectiveness of guidel<strong>in</strong>e<br />
implementation?<br />
See guidel<strong>in</strong>e<br />
section<br />
6.1<br />
6.2<br />
6.4<br />
6.4.1<br />
6.4.2<br />
6.5<br />
See guidel<strong>in</strong>e<br />
section<br />
8<br />
Annexes<br />
57
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