Flashcards in Antibiotics Deck (25):
If used prophylactically, antibiotics need to be in the tissue before the time of wounding and contamination (ie. there must be a pre-operative dose).
The most frequently isolated pathogens causing surgical site infections are S.aureus, coagulase-negative Staph, Enterococcus spp., and Propionbacterium acnes.
Tobacco and alcohol use are not risk factors for the development of surgical site infections.
Higher rates of surgical site infections are associated with procedures below the knee, wedge excisions of the lip or ear, skin grafts, and lesions in the groin.
Patients on warfarin and/or aspirin tend to have higher rates of surgical site infection.
Diabetes mellitus is a risk factor that has been associated with defects in the leukocyte mobilization
Patients with well-controlled diabetes mellitus still have increased infection rates compared with people who do not have diabetes mellitus.
Treating nasal carriage of S.aureus may reduce the risk of surgical site infection.
HIV infection itself predisposes to surgical site infection.
Shaving of hair the night before an operation is associated with lower rates of surgical site infection.
F Clipping hair immediately before the procedure is better, or don’t clip at all.
Antibiotics should be given prophylactically in all cases of Class II (clean-contaminated) wounds, eg. wounds in oral cavity, respiratory tract, axilla/perineum.
F Class III and IV only.
If it is necessary to give antibiotic prophylaxis, only a single preoperative dose is recommended.
Wound infection of wounds healing by secondary intention is rare if the wounds are properly cared for.
The overall rate of infection is low but in procedures in the groin, skin grafts, ledge excisions of the lip or ear, and procedures below the knee the rate of infection reaches >2%
Topical antibiotics should be used for all dermatological surgery wounds.
F Only Class III and IV wounds.
Facial laser resurfacing is considered a class II clean-contaminated type wound which does not require prophylactic antibiotics.
Post-operative surgical site infections usually present between post-operative days 2-4.
Endocarditis prophylaxis is required in all patients with a prior history of infective endocarditis.
Endocarditis prophylaxis is required in all patients who have ever had a repair of a congenital heart defect.
F Only within the first 6 months after the procedure, or if residual defects.
Endocarditis prophylaxis is required in all patients with a prosthetic heart valve.
Antibiotic prophylaxis is required in all patients who have had a joint replacement in the last 5 years.
F 2 years.
Antibiotic prophylaxis is required in all patients with a prior history of prosthetic joint infection.
Antibiotic prophylaxis is required in all patients with a joint replacement who have type I diabetes, HIV, malignancy or malnourishment.
Antibiotic prophylaxis is recommended for all patients who have cardiac pacemakers or internal defibrillators.