Antimicrobial Prophylaxis for Surgical Wounds: Guidelines for Clinical Care

Archives of Surgery

Volumn 128, Issue 1, 1993, Pages 79-88

  Page, Carey P ^a   Bohnen, John M A ^b   Fletcher, J Raymond ^c   McManus, Albert T ^d   Solomkin, Joseph S ^e   Wittmann, Dietmar H ^f  

^a UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO   (United States)

^b UNIVERSITY OF TORONTO   (Canada)

^c UNIVERSITY OF SOUTH ALABAMA   (United States)

^d US ARMY INSTITUTE OF SURGICAL RESEARCH   (United States)

^e UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE   (United States)

^f MEDICAL COLLEGE OF WISCONSIN   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AMINOGLYCOSIDE; ANTIBIOTIC AGENT; CEFAZOLIN; CEFMETAZOLE; CEFOTETAN; CEFOXITIN; CEPHALOSPORIN DERIVATIVE; CLINDAMYCIN; ERYTHROMYCIN; NEOMYCIN; PENICILLIN DERIVATIVE; VANCOMYCIN;

ANTIBIOTIC PROPHYLAXIS; APPENDECTOMY; BACTERIAL INFECTION; BILIARY TRACT SURGERY; BLOOD TOXICITY; CONFERENCE PAPER; DIARRHEA; DRUG CHOICE; DRUG COST; DRUG INDICATION; GYNECOLOGIC SURGERY; HEART SURGERY; HOSPITAL INFECTION; HUMAN; INFECTION CONTROL; INFECTION RISK; INTRAVENOUS DRUG ADMINISTRATION; MEDICAL DECISION MAKING; NEPHROTOXICITY; ORAL DRUG ADMINISTRATION; OTOTOXICITY; PRIORITY JOURNAL; RISK FACTOR; SURGICAL WOUND; THORAX SURGERY; THROMBOPHLEBITIS; WOUND INFECTION;

ANTIBIOTICS; CLINICAL PROTOCOLS; HUMAN; INFUSIONS, INTRAVENOUS; PREMEDICATION; RISK FACTORS; SOCIETIES, MEDICAL; SURGICAL PROCEDURES, OPERATIVE; SURGICAL WOUND INFECTION;

EID: 0027434640     PISSN: 00040010     EISSN: 15383644     Source Type: Journal    
DOI: 10.1001/archsurg.1993.01420130087014     Document Type: Article

References (99)

1. Haley RW, Schaberg DR, Crossley KB, Von Allmen SD, McGowan JE. Extra charges and prolongation of stay attributable to nosocomial infections: a prospective interhospital comparison. Am J Med. 1981;70:51-58.
2. Wenzel RP. Preoperative antibiotic prophylaxis. N Engl J Med. 1992; 326:337-339.
3. Ehrenkranz NJ, Blackwelder WC, Pfaff SJ, Poppe D, Yerg DE, Kaslow RA. Infections complicating low-risk cesarean sections in community hospitals: efficacy of antimicrobial prophylaxis. Am J Obstet Gynecol. 1990;162: 337-343.
4. National Academy of Sciences, National Research Council, Division of Medical Sciences, Ad Hoc Committee on Trauma. Postoperative wound infections: the influence of ultraviolet irradiation on the operating room and of various other factors. Ann Surg. 1964;160(suppl 2):1-196.
5. Ehrenkranz NJ. Surgical wound infection occurrence in clean operations: risk stratification for interhospital comparisons. Am J Med. 1981;70: 909-914.
6. Haley RW, Culver DH, Morgan WM, White JW, Emori TG, Hooton TM. Identifying patients at high risk of surgical wound infection. Am J Epidemiol. 1985;121:206-215.
7. Platt R, Zaleznik DF, Hopkins CC, et al. Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery. N Engl J Med. 1990;322: 153-160.
8. Antibiotic prophylaxis for herniorraphy and breast surgery. N Engl J Med. 1990;322:1884-1886.
9. Saxon A, Beall GN, Rohr AS, Adelman DC. Immediate hypersensitivity reactions to beta-lactam antibiotics. Ann Intern Med. 1987;107:204-215.
10. Wallace MR, Mascola JR, Oldfield EC. Red man syndrome: incidence, etiology, and prophylaxis. J Infect Dis. 1991;164:1180-1185.
11. Conte JE Jr, Cohen SN, Roe BB, Elashoff RM. Antibiotic prophylaxis and cardiac surgery: a prospective double-blind comparison of single-dose versus multiple-dose regimens. Ann Intern Med. 1972;76:943-949.
12. Archer GL, Tenenbaum MJ. Antibiotic-resistant Staphylococcus epidermidis in patients undergoing cardiac surgery. Antimicrob Agents Chemother. 1980;17:269-272.
13. Archer GL, Armstrong BC. Alteration of staphylococcal flora in cardiac surgery patients receiving antibiotic prophylaxis. J Infect Dis. 1983;147: 642-649.
14. Sanders CC, Sanders WE. Type I beta-lactamases of gram negative bacteria: interactions with beta-lactam antibiotics. J Infect Dis. 1986;154: 792-800.
15. Privitera G, Scarpellini P, Ortisi G, Nicastro G, Nicolin R, de Lalla F. Prospective study of Clostridium difficile intestinal colonization and disease following single-dose antibiotic prophylaxis in surgery. Antimicrob Agents Chemother. 1991;35:208-210.
16. Burke JF. The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery. 1961;50:161-168.
17. Polk HC Jr, Lopez-Mayor JF. Postoperative wound infection: a prospective study of determinant factors and prevention. Surgery. 1969;66: 97-103.
18. Galanduik S, Polk HC Jr, Jagelman DG, Fazio VW. Re-emphasis of priorities in surgical antibiotic prophylaxis. Surg Gynecol Obstet. 1989;169: 219-222.
19. Bergamini TM, Polk HC Jr. Pharmacodynamics of antibiotic penetration of tissue and surgical prophylaxis. Surg Gynecol Obstet. 1989;168:283-289.
20. DiPiro JT, Cheung RPF, Bowden TA, Mansberg JA. Single dose systemic antibiotic prophylaxis of surgical wound infections. Am J Surg. 1986;152:552-559.
21. Ariano RE, Zhanel GG. Antimicrobial prophylaxis in coronary bypass surgery: a critical appraisal. DICP. 1991;25:478-484.
22. Peterson CD, Shultz NJ, Goldberg DE. Pharmacist monitoring of the timing of preoperative antibiotic administration. Am J Hosp Pharm. 1990; 47:384-386.
23. Dobrzanski S, Lawley DI, McDermott I, Selby M, Ausobsky JR. The impact of guidelines on perioperative antibiotic administration. J Clin Pharm Ther. 1991;16:19-24.
24. Scher KS, Bernstein JM, Arenstein GL, Sorensen C. Reducing the cost of surgical prophylaxis. Am Surg. 1990;56:32-35.
25. Halasz NA. Wound infection and topical antibiotics: the surgeon's dilemma. Arch Surg. 1977;112:1240-1244.
26. Andersen B, Bendtsen A, Holbraad L, Schantz A. Wound infections after appendicectomy. Acta Chir Scand. 1972;138:531-536.
27. Bergamini TM, Lamont PM, Cheadle WG, Polk HC Jr. Combined topical and systemic antibiotic prophylaxis in experimental wound infection. Am J Surg. 1984;147:753-756.
28. Seco JL, Ojeda E, Reguilon C, et al. Combined topical and systemic antibiotic prophylaxis in acute appendicitis. Am J Surg. 1990;159:226-230.
29. Lowry KF, Curtis GM. Delayed suture in the management of wounds: analysis of 721 traumatic wounds illustrating the influence of time interval in wound repair. Am J Surg. 1950;80:280-287.
30. Lipton S, Estrin J, Kamathe ML, Haq I, Berkowitz S. Surface hydrogen ion concentration as a determinant in timing delayed closure of wounds. Surg Gynecol Obstet. 1974;139:189-192.
31. Kaiser AB. Antimicrobial prophylaxis in surgery. N Engl J Med. 1986; 315:1129-1138.
32. Gorbach SL. The role of cephalosporins in surgical prophylaxis. J Antimicrob Chemother. 1989;23(suppl D):61-70.
33. Antimicrobial prophylaxis in surgery. Med Lett Drugs Ther. 1992;34: 5-8.
34. Kernodle DS. Surgical prophylaxis: how far have we really come? Pharmacotherapy. 1988;8(suppl):11-13.
35. Slama TG, Sklar SJ, Misinski J, Fess SW. Randomized comparison of cefamandole, cefazolin, cefuroxime prophylaxis in open heart surgery. Antimicrob Agents Chemother. 1986;29:744-747.
36. Miedzinski LJ, Callaghan JC, Fanning EA, et al. Antimicrobial prophylaxis for open heart operations. Ann Thorac Surg. 1990;50:800-807.
37. Gelfand MS, Simmons BP, Schoettle P, et al. Cefamandole versus cefonicid prophylaxis in cardiovascular surgery: a prospective study. Ann Thorac Surg. 1990;49:435-439.
38. Szilagi DE, Smith RF, Elliott JP, Vrandecic MP. Infection in arterial reconstruction with synthetic grafts. Ann Surg. 1972;186:321-333.
39. Goldstone J, Moore WS. Infection in vascular prostheses: clinical manifestations and surgical management. Am J Surg. 1974;128:225-233.
40. Landreneau MD, Raju S. Infections after elective bypass surgery for lower limb ischemia: the influence of preoperative transcutaneous arteriography. Surgery. 1981;90:956-961.
41. Durham JR, Malone JM, Bernhard VM. The impact of multiple operations on the importance of arterial wall cultures. J Vasc Surg. 1987;5:160-169.
42. Kaiser AB, Clayson KR, Mulherin JL Jr, et al. Antibiotic prophylaxis in vascular surgery. Ann Surg. 1978;188:283-289.
43. Pitt HA, Postier RG, MacGowan WAL, Frank LW. Prophylactic antibiotics in vascular surgery: topical, systemic, or both? Ann Surg. 1980;192: 356-364.
44. Nelson CL. Prevention of sepsis. Clin Orthop. 1987;222:66-72.
45. Taylor GJ, Bannister GC, Calder S. Perioperative wound infection in elective orthopaedic surgery. J Hosp Infect. 1990;16:241-247.
46. Van Meirhaeghe J, Verdonk R, Verschraegen G, Myny P, Paeme G, Claessens H. Flucloxacillin compared with cefazolin in short-term prophylaxis for clean orthopedic surgery. Arch Orthop Trauma Surg. 1989;108: 308-313.
47. Tengve B, Kjellander J. Antibiotic prophylaxis in operations on trochanteric femoral fractures. J Bone joint Surg Am. 1978;60:97-99.
48. Hughes SP, Miles RS, Littlejohn M, Brown E. Is antibiotic prophylaxis necessary for internal fixation of low-energy fractures? Injury. 1991;22:111-113.
49. Jrgensen LN, Andreasen JJ, Nielsen PT, Kondradsen LA, Hartzen SH. Dicloxacillin concentrations in amputation. Acta Orthop Scand. 1989;60: 617-620.
50. Mars M, Elson KI, Salisbury RT, Robbs JV. Do pre-operative antibiotics reach the operative field in amputation surgery for peripheral vascular disease? a pilot study. S Afr J Surg. 1990;28:58-61.
51. Haines SJ. Efficacy of antibiotic prophylaxis in clean neurosurgical operations. Neurosurgery. 1989;24:401-405.
52. Geraghty J, Feely M. Antibiotic prophylaxis in neurosurgery. J Neurosurg. 1984;60:724-726.
53. Bullock R, van Dellen JR, Ketelbey W, Reinach SG. A double-blind placebo-controlled trial of perioperative prophylactic antibiotics for elective neurosurgery. J Neurosurg. 1988;69:687-691.
54. van Ek B, Dijkmans BA, van Dulken H, Mouton RP, Hermans J, van Furth R. Effect of cloxacillin prophylaxis on the bacterial flora of craniotomy wounds. Scand J Infect Dis. 1990;22:345-352.
55. Cartmill TD, al Zahawi MF, Sisson PR, et al. Five days versus one day of penicillin as prophylaxis in elective neurosurgical operations. J Hosp Infect. 1989;14:63-68.
56. Johnson JT, Yu VL. Role of aerobic gram-negative rods, anaerobes, and fungi in wound infection after head and neck surgery: implications for antibiotic prophylaxis. Head Neck. 1989;11:27-29.
57. Friberg D, Lundberg C. Antibiotic prophylaxis in major head and neck surgery when clean-contaminated wounds are established. Scand J Infect Dis Suppl. 1990;70:87-90.
58. Peterson LJ. Antibiotic prophylaxis against wound infections in oral and maxillofacial surgery. J Oral Maxillofac Surg. 1990;48:617-620.
59. Carrau RL, Byzakis J, Wagner RL, Johnson JT. Role of prophylactic antibiotics in uncontaminated neck dissections. Arch Otolaryngol Head Neck Surg. 1991;117:194-195.
60. Ilves R, Cooper JD, Todd TRJ, Pearson FG. Prospective, randomized double-blind study using prophylactic cephalothin for major, elective, general thoracic operations. J Thorac Cardiovasc Surg. 1981;81:813-817.
61. Krasnik M, Thus J, Frimodt-Miller N. Antibiotic prophylaxis in non-cardiac thoracic surgery: a double-blind study of penicillin vs cefuroxime. Scand J Thorac Cardiovasc Surg. 1991;25:73-76.
62. Olak J, Jeyasingham K, Forrester-Wood C, Hutter J, al-Zeerah M, Brown E. Randomized trial of one-dose versus six-dose cefazolin prophylaxis in elective general thoracic surgery. Ann Thorac Surg. 1991;51:956-958.
63. Gatehouse D, Dimock F, Burdon DW, Alexander-Williams J, Keighley MR. Prediction of wound sepsis following gastric operation. Br J Surg. 1978;65:551-554.
64. Pories WJ, Van Rij AM, Burlingham BT, Fulghum RS, Meelheim D. Prophylactic cefazolin in gastric bypass surgery. Surgery. 1981;90:426-432.
65. Lewis RT, Goodall RG, Marien B, Park M, Lloyd-Smith W, Wiegand FM. Efficacy and distribution of single-dose preoperative antibiotic prophylaxis in high-risk gastroduodenal surgery. Can J Surg. 1991;34:117-122.
66. Chetlin SH, Elliott DW. Biliary bacteremia. Arch Surg. 1971;102:303-307.
67. Keighley MRB, Alexander-Williams J. Multivariate analysis of clinical and operative findings associated with biliary sepsis. Br J Surg. 1976;63:528-531.
68. Lewis RT, Goodall RG, Marien B, Park M, Lloyd-Smith W, Wiegand FM. Biliary bacteria, antibiotic use, and wound infection in surgery of the gallbladder and common bile duct. Arch Surg. 1987;122:44-47.
69. Wells GR, Taylor EW, Lindsay G, Morton L. Relationship between bile colonization, high-risk factors and postoperative sepsis in patients undergoing biliary tract operations while receiving a prophylactic antibiotic: West of Scotland Surgical Infection Study Group. Br J Surg. 1989;76:374-377.
70. Strachan CJL, Black J, Powis SJA, Waterworth TA. Prophylactic use of cephazolin against wound sepsis after cholecystectomy. BMJ. 1977;1:1254-1256.
71. Targarona EM, Garau J, Munoz-Ramos C, et al. Single-dose antibiotic prophylaxis in patients at high risk for infection in biliary surgery: a prospective and randomized study comparing cefonicid with mezlocillin. Surgery. 1990;107:327-334.
72. Sarr MG, Parikh KJ, Sanfey H, Minken SL, Cameron JL. Topical antibiotics in high-risk biliary surgical patients: a prospective randomized study. Am J Surg. 1988;155:337-342.
73. Gottrup F. Prophylactic metronidazole in prevention of infection after appendicectomy: report of a double blind trial. Acta Chir Scand. 1980;146: 133-136.
74. Bauer T, Vennits B, Holm B, et al. Antibiotic prophylaxis in acute nonperforated appendicitis: The Danish Multicenter Study Group III. Ann Surg. 1989;209:307-311.
75. Winslow RE, Dean RE, Harley JW. Acute nonperforating appendicitis: efficacy of brief antibiotic prophylaxis. Arch Surg. 1983;118:651-655.
76. Browder W, Smith JW, Vivoda LM, Nichols RL. Nonperforative appendicitis: a continuing surgical dilemma. J Infect Dis. 1989;159:1088-1094.
77. Nichols RL, Broido P, Condon RE, Gorbach SL, Nyhus LM. Effect of preoperative neomycin-erythromycin intestinal preparation on the incidence of infectious complications following colon surgery. Ann Surg. 1973;178: 453-462.
78. Clarke JS, Condon RE, Bartlett JG, et al. Preoperative oral antibiotics reduced septic complications of colon operations: results of a prospective randomized, double-blind clinical study. Ann Surg. 1977;186:251-259.
79. Lewis RT, Goodall RG, Marien B, Lloyd-Smith W, Park M, Wiegand FM. Is neomycin necessary for bowel preparation in surgery of the colon? oral neomycin plus erythromycin versus erythromycin-metronidazole. Can J Surg. 1989;32:265-270.
80. Condon RE, Bartlett JG, Greenlee H, et al. Efficacy of oral and systemic antibiotic prophylaxis in colorectal operations. Arch Surg. 1983;118:496-502.
81. Stellato TA, Danziger LH, Gordon N, et al. Antibiotics in elective colon surgery: a randomized trial of oral, systemic, and oral/systemic antibiotics for prophylaxis. Am Surg. 1990;56:251-254.
82. Schoetz DJ Jr, Roberts PL, Murray JJ, Coller JA, Veidenheimer MC. Addition of parenteral cefoxitin to regimen of oral antibiotics for elective colorectal operations: a randomized prospective study. Ann Surg. 1990;212: 209-212.
83. Morris DL, Wilson SR, Pain J, et al. A comparison of aztreonam/metronidazole and cefotaxime/metronidazole in elective colorectal surgery: antimicrobial prophylaxis must include gram-positive cover. J Antimicrob Chemother. 1990;25:673-678.
84. Rodolico G, Puleo S, Blandino G, et al. Colorectal surgery: short-term prophylaxis with clindamycin plus aztreonam or gentamicin. Rev Infect Dis. 1991;13(suppl 7):612-615.
85. Raahave D, Hesselfeldt P, Pedersen T, Zachariassen A, Kahn D, Hansen OH. No effect of topical ampicillin prophylaxis in elective operations of the colon or rectum. Surg Gynecol Obstet. 1989;168:112-114.
86. Mugford M, Kingston J, Chalmers I. Reducing the incidence of infection after caesarean section: implications of prophylaxis with antibiotics for hospital resources. BMJ. 1989;299:1003-1006.
87. Ford LC, Hammil HA, Lebherz TB. Cost-effective use of antibiotic prophylaxis for cesarean section. Am J Obstet Gynecol. 1987;157:506-510.
88. Carlson C, Duff P. Antibiotic prophylaxis for cesarean delivery: is an extended-spectrum agent necessary? Obstet Gynecol. 1990;76:343-346.
89. Watts DH, Hillier SL, Eschenbach DA. Upper genital tract isolates at delivery as predictors of post-cesarean infections among women receiving antibiotic prophylaxis. Obstet Gynecol. 1991;77:287-292.
90. Hemsell DL, Heard MC, Nobles BJ, Bawdon RE, Hemsell PG. Single dose prophylaxis for vaginal and abdominal hysterectomy. Am J Obstet Gynecol. 1987;157:498-501.
91. Nichols RL, Smith JW, Klein DB, et al. Risk of infection after penetrating abdominal trauma. N Engl J Med. 1984;311:1065-1070.
92. Thadepalli H, Gorbach SL, Norsen J, Broido PW, Norsen J, Nyhus L. Abdominal trauma, anaerobes, and antibiotics. Surg Gynecol Obstet. 1973; 137:270-276.
93. Kreis DJ, Augenstein D, Martinez O, Echenique M. A prospective randomized study of moxalactam versus gentamicin and clindamycin in penetrating abdominal trauma. Surg Gynecol Obstet. 1986;163:1-4.
94. Nelson RM, Benitez PR, Newell MA, Wilson RF. Single-antibiotic use for penetrating abdominal trauma. Arch Surg. 1986;121:153-156.
95. O'Donnell V, Mandal AK, Lou MA, Thadepalli H. Evaluation of carbenicillin and a comparison of clindamycin and gentamicin combined therapy in penetrating abdominal trauma. Surg Gynecol Obstet. 1978;147:525-528.
96. Moore FA, Moore EE, Ammons LA, McCroskey BL. Presumptive antibiotics for penetrating abdominal wounds. Surg Gynecol Obstet. 1989; 169:99-103.
97. Oreskovich MR, Dellinger EP, Lennard ES, Wertz M, Carrico CJ, Minshew BH. Duration of preventive antibiotic administration for penetrating abdominal trauma. Arch Surg. 1982;117:200-205.
98. Dellinger EP, Wertz MJ, Lennard ES, Oreskovich MR. Efficacy of short-course antibiotic prophylaxis after penetrating intestinal injury. Arch Surg. 1986;121:23-30.
99. Demetriades D, Lakhoo M, Pezikis A, Charalambides D. Short-course antibiotic prophylaxis in penetrating abdominal injuries: ceftriaxone versus cefoxitin. Injury. 1991;22:20-24.