Antimicrobial prophylaxis in surgery: an international survey

Area of Science:

• Surgical Infectious Diseases
• Antimicrobial Stewardship
• Clinical Practice Guidelines

Background:

• Current clinical practices for antimicrobial prophylaxis (AMP) in surgical settings were examined.
• Investigated adherence to established guidelines for AMP administration.

Purpose of the Study:

• To assess the real-world application of antimicrobial prophylaxis protocols in various surgical specialties.
• To identify variations and deviations from recommended AMP practices among surgeons.

Main Methods:

• A survey was administered to surgeons in general surgery, orthopedics, gynecology, and cardiac surgery.
• Data collected on timing of first antimicrobial dose, duration of prophylaxis, and specific regimen choices.

Main Results:

• A significant proportion of surgeons (26.1%) initiated the first antimicrobial dose outside the recommended 1-hour window before incision.
• Over 27% of surgeons continued AMP for two or more days post-surgery, contradicting guidelines.
• Notable regional differences in AMP practices were observed between Europe and North America.

Conclusions:

• Self-reported antimicrobial prophylaxis strategies in daily practice show significant variability.
• A call for uniform, evidence-based antimicrobial prophylaxis practices is emphasized due to rising antimicrobial resistance.