ORIGINAL ARTICLES   

Chirurgia 2004 August;17(4):123-6

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: Italian

Antibiotic prophylaxis in clean surgery

Coli P.

Aim. The indiscriminate use of antibiotics in surgery has led to increased health care costs and a rise in antibiotic resistance. In response to these problems, we carried out a study on prophylactic antibiotic therapy in 100 patients who underwent clean surgical procedures. A review of the literature was also conducted.
Methods. We evaluated the efficacy of preoperative prophylactic antibiotic therapy for skin infections in 100 patients who underwent hemia repair or saphenous vein stripping at our hospital. Ninety-seven patients received cephalosporin as infection prophylaxis.
Results. Only 1 (1%) case of skin infection developed in an emergency hemia repair patient. The literature review revealed that in clean surgical procedures performed without antibiotic therapy the infection rate is 3%. Moreover, it was found that guidelines on prophylactic antibiotic therapy in surgery are often lacking, antibiotics are given at doses and timing that are inadequate for protection, and that antibiotics are frequently administered even when they are not needed. Studies indicate that when antibiotic therapy is instituted, the drug should be administered intravenously several hours before the operation and after careful consideration of possible pathogens.
Conclusion. After critical review of our approach to prophylactic antibiotic therapy in clean surgery, we believe that antibiotics should be given only when the operation involves prosthesis implantation or immunosuppressed patients or those with neoplastic disease.