Medicine and surgery notes

Apr 24th, 2015
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MRTH Department of Reproductive HealthProtocol for Antibiotic Use in SurgeryI. IntroductionThe goal of antimicrobial prophylaxis is to eradicate or retard the growth of endogenous microorganisms that may cause surgical site infection. Antibiotics should be used when there is an elevated probability of microbial contamination during gynecologic surgery (eg, surgical transection of the vagina) and the incidence of postoperative infection is high. The antibiotic chosen for prophylaxis should be effective against bacteria found in most gynecological infections, but not an agent used routinely for treatment of serious infectious complications. In addition, the antibiotic should be of low toxicity and able to achieve appropriate tissue levels in the surgical field. Randomized trials have consistently demonstrated the efficacy of single dose pre-operative antibiotic prophylaxis for vaginal hysterectomy, abdominal hysterectomy and cesarean section for the reduction in infectious complications. (See references below.) Patients who receive prophylactic antibiotics within a two hour "window" period before the initial incision have lower rates of surgical site infection than patients who receive them either too early or postoperatively.Cephalosporins are the drugs of choice for prophylaxis in hysterectomy because of their low incidence of allergy and side effects, broad antibacterial spectrum, long half-life, and low cost. They are usually given as a single intravenous dose

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