Antiobiotic prophylaxis to prevent surgical site infections

Surgical site infections are the most common nosocomial infections in surgical patients, accounting for approximately 500,000 infections annually. Surgical site infections also account for nearly 4 million excess hospital days annually, and nearly $2 billion in increased health care costs. To reduce the burden of these infections, a partnership of national organizations, including the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention, created the Surgical Care Improvement Project and developed six infection prevention measures. Of these, three core measures contain recommendations regarding selection of prophylactic antibiotic, timing of administration, and duration of therapy. For most patients undergoing clean-contaminated surgeries (e.g., cardiothoracic, gastrointestinal, orthopedic, vascular, gynecologic), a cephalosporin is the recommended prophylactic antibiotic. Hospital compliance with infection prevention measures is publicly reported. Because primary care physicians participate in the pre- and postoperative care of patients, they should be familiar with the Surgical Care Improvement Project recommendations.