[Antibiotic prophylaxis in surgery--background, guidelines, requirements]

Antibiotic prophylaxis in surgery represents a short antibiotic course given immediately before the procedure in order to prevent the development of a surgical site infection. The basic principle of the prophylaxis is, to maintain, during the entire surgery, effective concentrations of an antibiotic, active against the commonest pathogens. The decision for the use of prophylaxis depends on the particular risk that patient to develop infection, the severity of consequences of infection and the effectiveness of prophylaxis in this procedure. The prophylaxis is given i.v., ideally within 30 minutes of induction of anesthesia In most of procedures one single dose, which is identical with the therapeutic one, is sufficient. Supplementary doses are indicated in blood loss > 1500 ml. For patients presenting an allergy to penicillin, non-beta lactams should be included. The Guidelines for Antibiotic prophylaxis of Scotland, SIGN, and Russia, are being reviewed as models of contemporary guidelines. The experts' guidelines should be adapted in to a local policy of Antibiotic prophylaxis in the individual hospitals. Antibiotic prophylaxis should be registered and periodically - audited.