Perioperative antibiotic prophylaxis in adults - Sistema Nazionale ...

impact is the same, preference should be given to the one with the lowest purchaseprice and the lowest costs of preparation and administration 135 .Dosage selectionIt is generally accepted as good practice that the dosage of an antibiotic required forprophylaxis is the same as that used in therapy; the dosage selected should ensureserum levels of antibiotic exceeding the MIC for the pathogens likely to beencountered 22,25,26 .Annex 1 shows the antibiotics recommended by the panel and the initial doses thatshould be administered, based on dosages used in clinical studies and thoserecommended in the major guidelines. If it is decided to prolong prophylaxis for 24hours, the dosages and intervals of administration are generally the same as thoseused for treatment.Recommendation# The single dose of antibiotic used as prophylaxis is, in most cases, the same as amedium-high therapeutic dose.Route of administrationThe most reliable means of ensuring effective levels of the antibiotic in the blood andoperative site tissues is an intravenous administration 30-60 minutes before the skinis incised 23 .Serum levels after oral or intramuscular administration, on the other hand, areaffected not only by the dosage administered but also by the speed of absorption andthe bio-availability of the drug, and may therefore vary between individuals. It is alsoimportant to remember that organisational considerations make it more difficult torespect the timing if the antibiotic is administered outside the operating theatre.The intravenous administration of antibiotic prophylaxis inside the operating theatreis thus the only method supported by a substantial evidence base.