Antibiotics prophylaxis in surgery. Part 1: gastroenterological surgeries

Surgical site infections account for ~15% of nosocomial infections and are associated with prolonged hospital stay and increased costs. Prophylactic use of antibiotics aims at reducing the incidence of postsurgical wound infection. Inappropriate prophylaxis, whether unnecessary use of broad-spectrum agents or continuation of therapy beyond the recommended time period, is frequently seen. Indeed, this increases the risk of adverse effects and promotes the emergenceof resistant organisms. Controversy remains as to the necessity of prophylaxis in specific surgical procedures, as well as with regard to the duration of prophylaxis. The aim of this review is to discuss the criteria upon which decisions pertaining to the use of prophylactic antibiotics are based using the best clinical evidence available. Special emphasis is directed towards the selection and proper time and duration of administration. This review focuses on gastroenterological surgeries. Analysesof other surgeries will follow.