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Depending on the type of surgery and anticipated contamination associated with it, combinations of different agents or different routes of administration (e.g. intravenous and oral antibiotics) might be beneficial in reducing perioperative adverse events. [6] [7] For prophylaxis in surgery, only antibiotics with good tolerability should be used.
Intravenous prophylactic antibiotics are recommended, to be administered within one hour from the beginning of the surgical procedure. [8] In addition to i.v. prophylaxis, oral antibiotic prophylaxis has been demonstrated to be beneficial in reducing surgical site infections after elective large bowel surgery.
Dental antibiotic prophylaxis is the administration of antibiotics to a dental patient for prevention of harmful consequences of bacteremia, that may be caused by invasion of the oral flora into an injured gingival or peri-apical vessel during dental treatment.
An infection is designated as an SSI if it develops at the site of a surgical wound, either because of contamination during surgery or as a result of postoperative complications. For the infection to be classified as an SSI, it should occur within 30 days after surgery or within 1 year if an implant is involved.
SCIP-INF-3: Prophylactic antibiotics discontinued within 24 h after surgery end time (48 h for cardiac patients) SCIP-INF-4: Cardiac surgery patients with controlled 6 A.M. postoperative serum glucose management (≤200 mg/dL) (added 2008) SCIP-INF-5: Postoperative surgical site infection diagnosed during index hospitalization
Methods to decrease surgical site infections in spine surgery include the application of antiseptic skin preparation (a.g. Chlorhexidine gluconate in alcohol which is twice as effective as any other antiseptic for reducing the risk of infection [9]), judicious use of surgical drains, prophylactic antibiotics, and vancomycin. [10]
Although infrequent, there can be complications such as bleeding, swelling, infection, nausea and vomiting. [21] Infection rates of up to 7% are reported after orthognathic surgery; antibiotic prophylaxis reduces the risk of surgical site infections when the antibiotics are given during surgery and continued for longer than a day after the operation.
According to the American Dental Association: in patients with prosthetic joint implants, prophylactic antibiotics prior to routine dental procedures are generally not recommended in the prevention of PJI. However specific circumstances placing patients at higher risk, as determined by the dentist or other physicians, may warrant antibiotic ...