Perioperative antibiotic prophylaxis in adults - 2008

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Index

Summary of the principal recommendations

• General principles of prevention
• List of principal recommendations
• Local implementation of the guideline

Introduction

• Background
• Aims and recipients of antibiotic prophylaxis
• Need for the guideline
• New features of the updated guideline
• Issues addressed in the guideline

Methods

• Literature search
• Selection criteria and tools for methodological assessment
• Levels of evidence and grades of recommendations
• External review
• Next update, diffusion, implementation and assessment

Perioperative antibiotic phophylaxis in adults

• Question 1: What are the risk factors for surgical site infections and how do they affect the choice of antibiotic prophylaxis?
• Question 2: What are the benefits and risks of perioperative antibiotic prophylaxis?
• Question 3: In which operations has antibiotic prophylaxis been proved to reduce the risk of surgical site infections?
• Question 4: Which type of antibiotic is recommended for perioperative prophylaxis?  How and when should it be administered?

Implementation of the guideline

• Development of local guidelines
• Compliance with measures for prevention recommended by the Centers for Disease Control and Prevention (CDC)
• Implementation strategies most widely accredited in clinical studies
• Recording of drugs administered and minimum data set
• Key points and core indicators for auditing application of the guideline
• Data set needed to audit perioperative antibiotic prophylaxis

Annexes

• 1.Proposals for local implementation
• 2.Recommendations for antibiotic prophylaxis in bacterial endocarditis
• 3.Antibiotic prophylaxis in patients with prostheses or prosthetic devices
• 4.CDC/NHSN criteria for the definition of SSI
• 5.Classification of operations by duration  >75th percentile
• 6.Micro-organisms most frequently associated with postoperative infections
• 7.Auditing compliance with CDC rules for preventing SSI

Bibliography