Rational antimicrobial prophylaxis in orthopedics and trauma surgical practice

Abstract

Background : Antimicrobial prophylaxis in surgical practice is a concept that has been in practice for over 3 decades. The aim is to prevent surgical site infection (SSI), a menace acknowledged as the most common nosocomial infection in surgical patients. Over the years, several international guidelines have been published in the literature to guide the practice. Yet some surgeons still practice outside these guidelines especially in orthopedics and trauma surgical practice. This has led to emergence of resistant strains of bacteria and increased cost of healthcare. The only option left to check this problem therefore lies in the proper use of available antibiotics. The objective of this study was to review the current literature on the guidelines and practice of antibiotic prophylaxis in orthopedics and trauma surgery. Materials and Methods : A review of the literature on this subject was done on Medline, EBSCOhost database, and recent articles from relevant journals and texts. The database was searched using the keywords; antibiotic prophylaxis; orthopedic and trauma surgery. Results: There are several guidelines and protocols that were established from evidence based information. However, compliance to these guidelines amongst surgeons and health institutions is suboptimal for various reasons. This is associated with increased morbidity and cost of treatment. Conclusion : There is a need to be guided by evidence based guidelines in our antimicrobial prophylaxis practice; as surgery is both a science and an art.