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Surgical Antibiotic Prophylaxis in an Era of Antibiotic Resistance: Common Resistant Bacteria and Wider
Bradley D Menz1, Esmita Charani2,3, David L Gordon4,5
1SA Pharmacy, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia.
Abstract:
The increasing incidence of antimicrobial resistance (AMR) presents a global crisis to healthcare, with longstanding antimicrobial agents becoming less effective at treating and preventing infection. In the surgical setting, antibiotic prophylaxis has long been established as routine standard of care to prevent surgical site infection (SSI), which remains one of the most common hospital-acquired infections. The growing incidence of AMR increases the risk of SSI complicated with resistant bacteria, resulting in poorer surgical outcomes (prolonged hospitalisation, extended durations of antibiotic therapy, higher rates of surgical revision and mortality). Despite these increasing challenges, more data are required on approaches at the institutional and patient level to optimise surgical antibiotic prophylaxis in the era of antibiotic resistance (AR). This review provides an overview of the common resistant bacteria encountered in the surgical setting and covers wider considerations for practice to optimise surgical antibiotic prophylaxis in the perioperative setting.
Insights
Antimicrobial resistance (AMR) threatens surgical care, increasing surgical site infections (SSIs). Optimizing antibiotic prophylaxis is crucial to combat resistant bacteria and improve patient outcomes in the era of antibiotic resistance (AR).
Area of Science:
- Infectious Diseases
- Surgical Infections
- Antimicrobial Resistance
Background:
- Antimicrobial resistance (AMR) is a growing global health crisis, diminishing the effectiveness of existing antibiotics.
- Surgical site infections (SSIs) are common hospital-acquired infections, with AMR increasing the risk of severe complications and poorer surgical outcomes.
- Optimizing surgical antibiotic prophylaxis is essential in the face of rising antibiotic resistance (AR).
Purpose of the Study:
- To review common resistant bacteria encountered in surgical settings.
- To discuss strategies for optimizing surgical antibiotic prophylaxis in the era of antibiotic resistance (AR).
- To provide guidance on institutional and patient-level approaches to improve perioperative antibiotic use.
Main Methods:
- Literature review of common resistant bacteria in surgical settings.
- Analysis of current practices and challenges in surgical antibiotic prophylaxis.
- Synthesis of evidence for optimizing antibiotic use in the perioperative period.
Main Results:
- Identified key resistant bacteria posing threats in surgical environments.
- Highlighted the need for updated strategies to address AMR in SSIs.
- Emphasized the importance of a multi-faceted approach to antibiotic stewardship.
Conclusions:
- Effective surgical antibiotic prophylaxis is critical to mitigate the impact of AMR on SSIs.
- Further research and implementation of optimized strategies are needed at institutional and patient levels.
- Addressing antibiotic resistance is paramount for improving surgical outcomes and patient safety.
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