Prophylactic Antibiotics

Abstract

Prophylaxis can be defined as an action taken to prevent disease. Antibiotics are an important component of prophylaxis against surgical wound and other infective complications, together with preoperative patient preparation, good surgical technique and appropriate postoperative wound care. Antibiotics are not, and never can be, a substitute for the other three components. There is no doubt that antibiotic prophylaxis reduces postoperative infective complications, and it is also widely used in several non-surgical situations, such as the prevention of pneumococcal infection in asplenic patients, or to prevent secondary cases of meningococcal meningitis. Prophylaxis is also used for the prevention of endocarditis in patients with heart valve defects (particularly prosthetic valves) who are undergoing certain surgical procedures. In general, antibiotic prophylaxis should be used in surgical procedures when there is likely to be wound contamination, or when the consequences of infection (although rare) would be devastating, as in hip or heart valve replacement surgery. The aim is not to achieve tissue sterility at the time of surgery, but instead to reduce bacterial numbers to levels which are unlikely to overwhelm normal host defences.