Surgical Antibiotic Prophylaxis in an Era of Antibiotic Resistance: Common Resistant Bacteria and Wider Considerations for Practice

• Published in: Infection and drug resistance Vol. 14; pp. 5235 - 5252
• Main Authors: Menz, Bradley D, Charani, Esmita, Gordon, David L, Leather, Andrew J M, Moonesinghe, S Ramani, Phillips, Cameron J
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Analysis; Antibiotic resistance; Antibiotics; Antimicrobial agents; Antimicrobial resistance; antimicrobial stewardship; Bacteria; Bacterial infections; Blood transfusions; Ceftaroline; Disease prevention; Drug resistance; Drug resistance in microorganisms; Expenditures; Gram-negative bacteria; Health aspects; Infection; Infection control; Methicillin; Metronidazole; Mortality; Nafcillin; Nosocomial infections; Organisms; Patients; perioperative care; Prevention; Prophylaxis; Review; Risk factors; Skin; Staphylococcus infections; surgical antibiotic prophylaxis; Surgical outcomes; surgical site infection; Surgical site infections; Tinidazole; Australia; United Kingdom; United States > US; Europe; surgical antibiotic prophylaxis; antimicrobial stewardship; antibiotic resistance; perioperative care; surgical site infection
• ISSN: 1178-6973; 1178-6973
• DOI: 10.2147/IDR.S319780

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.