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Are Single-Dose Preoperative Antibiotic Regimens Really Appropriate?
Andrew H. Schmidt, MD
Arch Surg. 2007;142(6):576-577.
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There are many potential factors to consider in choosing (or comparing) an appropriate perioperative antibiotic regimen. One consideration is the infection rate at both the surgical site and remote sites, another is the potential development of antimicrobial resistance, a third consideration is cost, and yet another is the potential for adverse reactions to the antibiotic. Fonseca et al1 report the results of a "before-after" trial evaluating the rate of surgical site infection after changing from a 24-hour regimen to a single preoperative dose of cephazolin. The authors studied 12 299 patients in total, covering a wide range of surgical disciplines. They report an infection rate of 2.0% before and 2.1% after the change in their antibiotic protocol (P = .67).
The authors conclude that a 0.1% increase in the infection rate is statistically and clinically insignificant and justifies the use of their cost-saving protocol. Although a 0.1% . . . [Full Text of this Article]
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Are Single-Dose Preoperative Antibiotic Regimens Really Appropriate?—Reply
Silvia Nunes Szente Fonseca, Sônia Regina Melon Kunzle, Maria José Junqueira, Renata Teodoro Nascimento, José Ivan de Andrade, and Anna Sara Shafferman Levin
Arch Surg. 2007;142(6):577.
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Implementing 1-Dose Antibiotic Prophylaxis for Prevention of Surgical Site Infection
Silvia Nunes Szente Fonseca, Sônia Regina Melon Kunzle, Maria José Junqueira, Renata Teodoro Nascimento, José Ivan de Andrade, and Anna S. Levin
Arch Surg. 2006;141(11):1109-1113.
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