Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery

Massimo Sartelli¹, Marja A Boermeester², Miguel Cainzos³, Federico Coccolini⁴, Stijn W de Jonge², Kemal Rasa⁵, E Patchen Dellinger⁶, Deborah A McNamara⁷, Donald E Fry⁸, Yunfeng Cui⁹, Samir Delibegovic¹⁰, Zaza Demetrashvili¹¹, Belinda De Simone¹², George Gkiokas¹³, Timothy C Hardcastle¹⁴, Kamal M F Itani¹⁵, Arda Isik¹⁶, Francesco Maria Labricciosa¹⁷, Varut Lohsiriwat¹⁸, Sanjay Marwah¹⁹, Tadeja Pintar²⁰, Jennifer Rickard²¹, Vishal G Shelat²², Fausto Catena²³, Philip S Barie²⁴

Affiliations

¹ Department of Surgery, Macerata Hospital, 62100 Macerata, Italy.
² Department of Surgery, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, The Netherlands.
³ Department of Surgery, Hospital Clínico Universitario, 15706 Santiago de Compostela, Spain.
⁴ Department of Emergency and Trauma Surgery, Pisa University Hospital, University of Pisa, 55126 Pisa, Italy.
⁵ Department of Surgery, Anadolu Medical Center, 41200 Kocaeli, Turkey.
⁶ Department of Surgery, University of Washington, Seattle, WA 98195, USA.
⁷ Department of Colorectal Surgery, Beaumont Hospital, D09V2N0 Dublin, Ireland.
⁸ Department of Surgery, Northwestern University, Chicago, IL 60208, USA.
⁹ Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin 300100, China.
¹⁰ Department of Surgery, University Clinical Center of Tuzla, 75000 Tuzla, Bosnia and Herzegovina.
¹¹ Department General Surgery, Kipshidze Central University Hospital, Tbilisi 0162, Georgia.
¹² Department of Emergency and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy/Saint Germain en Laye, 78300 Poissy CEDEX, France.
¹³ Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece.
¹⁴ Department of Surgery, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Mayville 4058, South Africa.
¹⁵ Department of Surgery, VA Boston Health Care System, Boston University and Harvard Medical School, Boston, MA 02118, USA.
¹⁶ Division of General Surgery, School of Medicine, Istanbul Medeniyet University, 34700 Istanbul, Turkey.
¹⁷ Global Alliance for Infections in Surgery, 62100 Macerata, Italy.
¹⁸ Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
¹⁹ Department of Surgery, BDS Post-Graduate Institute of Medical Sciences, Rohtak 124001, India.
²⁰ Department of Abdominal Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
²¹ Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
²² Department of Hepato-Pancreatic-Biliary Surgery, Tan Tok Seng Hospital, Singapore 308433, Singapore.
²³ Department of Surgery, "Bufalini" Hospital, 47023 Cesena, Italy.
²⁴ Department of Surgery, Weill Cornell Medicine, E. Northport, New York, NY 11731, USA.

PMID: 37237811
PMCID: PMC10215114
DOI: 10.3390/antibiotics12050908

Review

Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery

Massimo Sartelli et al. Antibiotics (Basel). 2023.

. 2023 May 15;12(5):908.

doi: 10.3390/antibiotics12050908.

Authors

Affiliations

¹ Department of Surgery, Macerata Hospital, 62100 Macerata, Italy.
² Department of Surgery, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, The Netherlands.
³ Department of Surgery, Hospital Clínico Universitario, 15706 Santiago de Compostela, Spain.
⁴ Department of Emergency and Trauma Surgery, Pisa University Hospital, University of Pisa, 55126 Pisa, Italy.
⁵ Department of Surgery, Anadolu Medical Center, 41200 Kocaeli, Turkey.
⁶ Department of Surgery, University of Washington, Seattle, WA 98195, USA.
⁷ Department of Colorectal Surgery, Beaumont Hospital, D09V2N0 Dublin, Ireland.
⁸ Department of Surgery, Northwestern University, Chicago, IL 60208, USA.
⁹ Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin 300100, China.
¹⁰ Department of Surgery, University Clinical Center of Tuzla, 75000 Tuzla, Bosnia and Herzegovina.
¹¹ Department General Surgery, Kipshidze Central University Hospital, Tbilisi 0162, Georgia.
¹² Department of Emergency and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy/Saint Germain en Laye, 78300 Poissy CEDEX, France.
¹³ Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece.
¹⁴ Department of Surgery, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Mayville 4058, South Africa.
¹⁵ Department of Surgery, VA Boston Health Care System, Boston University and Harvard Medical School, Boston, MA 02118, USA.
¹⁶ Division of General Surgery, School of Medicine, Istanbul Medeniyet University, 34700 Istanbul, Turkey.
¹⁷ Global Alliance for Infections in Surgery, 62100 Macerata, Italy.
¹⁸ Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
¹⁹ Department of Surgery, BDS Post-Graduate Institute of Medical Sciences, Rohtak 124001, India.
²⁰ Department of Abdominal Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
²¹ Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
²² Department of Hepato-Pancreatic-Biliary Surgery, Tan Tok Seng Hospital, Singapore 308433, Singapore.
²³ Department of Surgery, "Bufalini" Hospital, 47023 Cesena, Italy.
²⁴ Department of Surgery, Weill Cornell Medicine, E. Northport, New York, NY 11731, USA.

PMID: 37237811
PMCID: PMC10215114
DOI: 10.3390/antibiotics12050908

Abstract

Surgical site infections (SSIs) are the most common adverse event occurring in surgical patients. Optimal prevention of SSIs requires the bundled integration of a variety of measures before, during, and after surgery. Surgical antibiotic prophylaxis (SAP) is an effective measure for preventing SSIs. It aims to counteract the inevitable introduction of bacteria that colonize skin or mucosa into the surgical site during the intervention. This document aims to guide surgeons in appropriate administration of SAP by addressing six key questions. The expert panel identifies a list of principles in response to these questions that every surgeon around the world should always respect in administering SAP.

Keywords: healthcare-associated infections; surgical antibiotic prophylaxis; surgical site infections.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Six key questions regarding the correct approach to surgical antibiotic prophylaxis (SAP).

See this image and copyright information in PMC

References

1. Haque M., Sartelli M., McKimm J., Bakar M.A. Healthcare-associated infections—An overview. Infect. Drug Resist. 2018;11:2321–2333. doi: 10.2147/IDR.S177247. - DOI - PMC - PubMed
1. Cassini A., Plachouras D., Eckmanns T., Abu Sin M., Blank H.-P., Ducomble T., Haller S., Harder T., Klingeberg A., Sixtensson M., et al. Burden of Six Healthcare-Associated Infections on European Population Health: Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study. PLoS Med. 2016;13:e1002150. doi: 10.1371/journal.pmed.1002150. - DOI - PMC - PubMed
1. Schreiber P.W., Sax H., Wolfensberger A., Clack L., Kuster S.P. The preventable proportion of healthcare-associated infections 2005–2016: Systematic review and meta-analysis. Infect. Control Hosp. Epidemiol. 2018;39:1277–1295. doi: 10.1017/ice.2018.183. - DOI - PubMed
1. Sartelli M., Guirao X., Hardcastle T.C., Kluger Y., Boermeester M.A., Raşa K., Ansaloni L., Coccolini F., Montravers P., Abu-Zidan F.M., et al. 2018 WSES/SIS-E consensus conference: Recommendations for the management of skin and soft-tissue infections. World J. Emerg. Surg. 2018;13:58. doi: 10.1186/s13017-018-0219-9. - DOI - PMC - PubMed
1. Allegranzi B., Zayed B., Bischoff P., Kubilay N.Z., de Jonge S., de Vries F., Gomes S.M., Gans S., Wallert E.D., Wu X., et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: An evidence-based global perspective. Lancet Infect. Dis. 2016;16:e288–e303. doi: 10.1016/S1473-3099(16)30402-9. - DOI - PubMed

Publication types

Actions

LinkOut - more resources

Full Text Sources
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery

Affiliations

Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources

Miscellaneous