Peri-operative antibacterial prophylaxis ======================= By Mohamed H. Rahman and James Anson ----------- Infection of incised tissue is an all too common yet potentially avoidable complication of any surgical procedure. “Surgical site infection” (SSI) is the preferred term, encompassing incisional (superficial or deep) and organ infections. Health care-associated infection (HAI) is a major concern for the NHS, affecting one in 10 patients admitted to hospital. The associated costs are estimated at £1bn each year and SSIs comprise 9 to 12 per cent of all HAIs. The issue of reducing HAIs is a key government strategy and is highlighted in several documents published over the past few years (see Panel). SSIs are associated with substantial morbidity and mortality, longer hospital stays and increased costs. During an operation, some bacterial contamination of the operative site is inevitable, either from the patient or from the environment. The use of antibiotics is, therefore, often an essential component of the care of patients undergoing surgery. Surgical antibacterial prophylaxis (SAP) refers to the administration of a pre-operative (and occasionally an intra-operative) antibiotic to reduce the risk of an SSI developing by inhibiting growth of contaminating bacteria. However, this is only part of a strategy to reduce the risk of SSIs and is no substitute for good surgical technique. Key documents relevant to healthcare associated infections ================================== The NHS plan (doh.gov.uk) Pharmacy in the future — implementing the NHS plan (doh.gov.uk) Winning ways — working together to reduce health care associated infection in England (doh.gov.uk) Getting ahead of the curve — a strategy for combating infectious diseases (doh.gov.uk) The management and control of hospital acquired infection in acute NHS trusts in England (nao.gov.uk/publications/nao _reports/9900230.pdf) UK antimicrobial resistance strategy and action plan (doh.gov.uk) The path of least resistance (doh.gov.uk) Surveillance of SSI in English hospitals (1997–2001) — a national surveillance and quality improvement programme: nosocomial infection national surveillance service (hpa.org.uk/infections/publications/ninns/NINSS...) ====== Identify knowledge gaps -------------------------- When is peri-operative antibacterial prophylaxis appropriate? What national guidance is currently available in relation to peri-operative antibacterial prophylaxis? Which antibiotics are commonly used to prevent surgical site infections? Before reading on, think about how this article may help you to do your job better. The Royal Pharmaceutical Society’s areas of competence for pharmacists are listed in “Plan and record”. This article relates to “clinical pharmacy” (see appendix 4 of “Plan and record”). ===================== Read the full article PDF ==================
Posted on: Sun, 16 Mar 2014 05:23:59 +0000
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