Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec 7:14:5235-5252.
doi: 10.2147/IDR.S319780. eCollection 2021.

Surgical Antibiotic Prophylaxis in an Era of Antibiotic Resistance: Common Resistant Bacteria and Wider Considerations for Practice

Bradley D Menz  1 , Esmita Charani  2   3 , David L Gordon  4   5 , Andrew J M Leather  6 , S Ramani Moonesinghe  7   8 , Cameron J Phillips  1   4   9
Affiliations
Review

Surgical Antibiotic Prophylaxis in an Era of Antibiotic Resistance: Common Resistant Bacteria and Wider Considerations for Practice

Bradley D Menz et al. Infect Drug Resist. .

Abstract

The increasing incidence of antimicrobial resistance (AMR) presents a global crisis to healthcare, with longstanding antimicrobial agents becoming less effective at treating and preventing infection. In the surgical setting, antibiotic prophylaxis has long been established as routine standard of care to prevent surgical site infection (SSI), which remains one of the most common hospital-acquired infections. The growing incidence of AMR increases the risk of SSI complicated with resistant bacteria, resulting in poorer surgical outcomes (prolonged hospitalisation, extended durations of antibiotic therapy, higher rates of surgical revision and mortality). Despite these increasing challenges, more data are required on approaches at the institutional and patient level to optimise surgical antibiotic prophylaxis in the era of antibiotic resistance (AR). This review provides an overview of the common resistant bacteria encountered in the surgical setting and covers wider considerations for practice to optimise surgical antibiotic prophylaxis in the perioperative setting.

Keywords: antibiotic resistance; antimicrobial stewardship; perioperative care; surgical antibiotic prophylaxis; surgical site infection.

PubMed Disclaimer

Conflict of interest statement

Dr Esmita Charani reports personal fees from Pfizer, outside the submitted work. Dr Andrew JM Leather reports grants from Economic and Social Research Council (ESRC). The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Stages affecting risk of surgical site infection with antibiotic-resistant bacteria.
Figure 2
Figure 2
Proposed flow chart for surgical antibiotic prophylaxis in the era of antibiotic resistance.
See this image and copyright information in PMC

References

    1. O’Neill J. Tackling drug-resistant infections globally: final report and recommendations. Government of the United Kingdom; 2016.
    1. World Health Organization. World action plan on antimicrobial resistance; 2015.
    1. Ademe M, Girma F. Candida auris: from multidrug resistance to pan-resistant strains. Infect Drug Resist. 2020;13:1287–1294. doi:10.2147/IDR.S249864 - DOI - PMC - PubMed
    1. Cosgrove SE. The relationship between antimicrobial resistance and patient outcomes: mortality, length of hospital stay, and health care costs. Clin Infect Dis. 2006;42(Supp2):S82–S89. doi:10.1086/499406 - DOI - PubMed
    1. Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health. 2015;109(7):309–318. doi:10.1179/2047773215Y.0000000030 - DOI - PMC - PubMed