Correct Use of Antibiotics for Prevention of Postoperative Infections

Abstract

 Antibiotic therapy for the prevention of postoperative infections is intended to achieve prophylaxis for surgical site infections (SSIs) and is not indicated for prevention of other postoperative infectious complications, including remote infections. The antibiotics used target bacteria that are normally present at a surgical site, whereas broad-spectrum antibiotics are not generally employed. Various antibiotics are recommended for the prevention of postoperative infections, including cefazolin (CEZ) or sulbactam/ampicillin (SBT/ABPC) for clean surgical wounds, and cefotiam (CTM), a second-generation cephamycin (cefmetazole: CMZ), an oxacephem (flomoxef: FMOX), or a combination of CEZ and metronidazole (MNZ) for clean-contaminated wounds. Administration of these antibiotics should be started within one hour prior to surgery. The dosage and the number of doses of these antibiotics should be adjusted depending on the patient's body weight and renal function. In principle, administration of these antibiotics should cease within 24 hours after surgery.