Perioperative antibiotic prophylaxis in adults - Sistema Nazionale ...

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- unrepaired cyanotic heart disease or disease for which only palliativetreatment was given;- completely repaired congenital heart defect with prosthetic material ordevice, whether placed by surgery or by catheter intervention, during thefirst 6 months after the procedure- repaired congenital heart disease with residual defects at the site oradjacent to the site of a prosthetic patch or prosthetic device (whichinhibit endothelialisation);cardiac transplantation recipients who develop cardiac valvulopathyRECOMMENDATIONS FOR PATIENTS AT HIGH RISK OFENDOCARDITIS UNDERGOING PROCEDURES/OPERATIONS IN THEMOUTH OR RESPIRATORY TRACTDENTAL PROCEDURESProphylaxis is recommended for:• procedures that involve manipulation of gengival tissue or the periapical region ofteeth or perforation of the oral mucosaProphylaxis is NOT recommended for:• anaesthetic injections through non-infected tissue• dental radiographs• placement of removable prosthodontic or orthodontic appliances• adjustment of orthodontic appliances• extraction of deciduous teeth• bleeding from trauma to the lips or gumsN.B.: It is very important that patients at risk of endocarditis maintain healthy teeth.This can be ensured through regular cleaning of the teeth (with an ordinary or electrictoothbrush) and regular dental check-ups.
RESPIRATORY TRACT PROCEDURES AND OPERATIONSProphylaxis is recommended for:• invasive procedures involving an incision or biopsy of the mucosa (e.g.tonsillectomy and/or adenoidectomy).Prophylaxis is NOT recommended for:• bronchoscopy (unless it involves incision of the mucosa).N.B.: For operations where an infection is present (e.g. drainage of an abscess orempyema) the chosen antibiotic should be active against beta-haemolyticstreptococci. If a staphylococcus-associated infection is suspected the treatmentshould include a penicillin active against staphylococcus or a cephalosporin. If thestaphylococcus is likely to be meticillin-resistant or the patient is allergic to betalactams,treatment should include vancomycin.RECOMMENDATIONS FOR PATIENTS AT HIGH RISK OFENDOCARDITIS UNDERGOING PROCEDURES/OPERATIONS ONINFECTED GI OR GU TRACT OR ON INFECTED SKIN ORMUSCOSKELETAL TISSUEDIAGNOSTIC/SURGICAL PROCEDURES ON INFECTED GI OR GU TRACTProphylaxis should be considered EXCLUSIVELY when an infection or colonisationis present in :• patients undergoing diagnostic or surgical procedures; it is reasonable that thetherapeutic regimen include an antibiotic active against enterococci, such asampicillin, piperacillin, vancomycin;• patients undergoing cystoscopy or other elective manipulations of the urinary tractwhen an enterococcal colonisation or infection is present: it is reasonable toadminister an effective antibiotic prior to the procedure.
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SNLG17Perioperative antibiotic prop
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Perioperative antibiotic prophylaxi
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In this regard, the website of the
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MULTIDISCIPLINARY PANELFulvio Calis
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Società Italiana di Ortopedia e Tr
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RCT: Randomised Clinical (controlle
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Implementation strategies most wide
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1. Proper ventilation systems in th
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VI/B Clean-contaminated procedures
Page 21 and 22: # Radical prostatectomyRadical cyst
Page 23 and 24: I/A Antibiotic prophylaxis should b
Page 25 and 26: contact with the surgical field dur
Page 27 and 28: 3. Management of colonised or infec
Page 29 and 30: *measures strongly recommended and
Page 31 and 32: included (this issue has been marke
Page 33 and 34: possible, the evidence base for the
Page 35 and 36: The working group considered that t
Page 37 and 38: omission of more recent studies was
Page 39 and 40: particular circumstances. Nonethele
Page 41 and 42: Dirty:encountered or there is visib
Page 43 and 44: • the duration of surgery (when t
Page 45 and 46: colitis or diarrhoea. The prevalenc
Page 47 and 48: Where evidence of efficacy is avail
Page 49 and 50: (1-expected baseline risk) x expect
Page 51 and 52: Contamination of the operative site
Page 53 and 54: • exanthema (rash)Other less spec
Page 55 and 56: The steady increase in the frequenc
Page 57 and 58: impact is the same, preference shou
Page 59 and 60: II/A In most cases antibiotic proph
Page 61 and 62: For heart surgery performed with ex
Page 63 and 64: Implementation of the guidelineDeve
Page 65 and 66: in the field, and the distribution
Page 67 and 68: If the recommendations indicated in
Page 69 and 70: - type of antibiotic, dosage and ro
Page 71: diagnostic or surgical procedures a
Page 75 and 76: - cephalexin § 2 g 30-60 minutes b
Page 77 and 78: • Vascular graftsNo randomised co
Page 79 and 80: • infection of both superficial a
Page 81 and 82: - myocarditis, pericarditis- endoca
Page 83 and 84: Other CNS surgeryCaesarean sectionA
Page 85 and 86: 2. Preparation of the surgical team
Page 87 and 88: - For how many hours does the proto
Page 89 and 90: 11. Jobe BA, Grasley A, Deveney KE,
Page 91 and 92: 30. Scottish Intercollegiate Guidel
Page 93 and 94: 52. Wilcox MH, Cunniffe JG, Trundle
Page 95 and 96: 71. Aznar R, Mateu M, Miro JM, Gate
Page 97 and 98: 93. Preclik G, Grune S, Leser HG, L
Page 99 and 100: 113. Sawaya GF, Grady D, Kerlikowsk
Page 101 and 102: 133. Pitt HA, Postier RG, MacGowan
Page 103 and 104: 153. Ballow CH, Schentag JJ. Trends
Page 105 and 106: 170. van Dijk-van Dam MS, Moll FL,
Page 107 and 108: 188. Crowe MJ, Cooke EM. Review of
Page 109 and 110: 205. White A, Schneider T Improving
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Perioperative antibiotic prophylaxis in adults - Sistema Nazionale ...

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