Hopkins ABX Guide

Surgical Infections and Prophylaxis

How Serious are Surgical Infections?

Surgical infections are most often limited to the site of the surgical incision and usually aren’t serious. However, bacteria and other pathogenic microorganism can also be introduced to internal organs or blood, or spread from the incision site to bloodstream and via the latter, to other parts of the body and cause a potentially very serious infection.

Adherence to sterile techniques and practises dramatically reduces the risk of surgical infections but it doesn’t eliminate the risk completely. Pathogenic microorganisms can be introduced to the incision site and other parts of the body even by 100% sterile surgical instruments. The risk of surgical infections is especially high in patients with some underlying medical conditions or/and pre-existing infections, and in individuals with a prolonged hospital stay. But an infection can be developed by otherwise healthy individuals as well. To reduce the risk of surgical infections, many patients are prescribed antimicrobial prophylaxis which most often involves a preventive antibiotic therapy.

What is Antimicrobial Prophylaxis and How Effective It is in Prevention Surgical Infections?

Antimicrobial prophylaxis is a pre-surgical treatment, usually an antibiotic therapy the goal of which is to reduce the risk of surgical infections. This is achieved by reaching antibiotic concentration high enough to prevent the introduction and growth of pathogenic microorganisms. This requires selection of the most appropriate antibiotic(s) and sufficient dosage but it also requires the right timing in order to protect the key parts of the body during the entire surgical procedure.

The results of antimicrobial prophylaxis in Britain and around the world reveal that it is very effective in prevention of surgical infections. And besides improving the outcomes for the patients, it also helps save considerable amounts of money by reducing the duration of hospitalisation. But due to the issue of antibiotic resistance, antimicrobial prophylaxis isn’t recommended for the general population but instead, for patients who are at increased risk of developing surgical infections or/and at risk of potentially serious complications during recovery.

Antibiotics Used in Antimicrobial Prophylaxis

Antibiotics or rarely other antimicrobial medications used in antimicrobial prophylaxis are selected based on the bacteria/microorganism associated with a particular surgical procedure, risk of serious side effects and resistance as well as the patient’s overall health. Cephalosporins are the most commonly used antibiotics in antimicrobial prophylaxis but other groups of antibiotics are used as well.