New Guidelines Published to Prevent Infections from Surgery




Four professional organizations representing physicians and pharmacists have collaborated to publish new clinical practice guidelines to help prevent infections from surgery. The American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA) worked together to develop guidelines which were published in the American Journal of Health-System Pharmacy on February 1, and will be published concurrently in Surgical Infections.

Surgical site infections represent a substantial challenge for hospitals and patients, according to the U.S. Centers for Disease Control and Prevention (CDC). The agency estimates that more than two surgical site infections occur for every 100 procedures and are responsible for nearly 10 percent of deaths caused by hospital-acquired infections in the U.S., adding $10,000 to $25,000 to the cost of care per patient affected.

These new guidelines reflect major updates to current clinical practice and were developed to help clinicians determine the best antimicrobial usage to help prevent infections in patients undergoing surgery. The guidelines were developed through an interprofessional panel using an evidence-based approach and included consideration for the validity, reliability, and clinical applicability of current literature. The guidelines replace ASHP’s previous therapeutic guidelines on this topic, which were first published in 1992 and revised in 1999, as well as guidelines published previously by SIS and IDSA.

New sections added to the guidelines address:

  • Preoperative screening and decolonization of microbes, such as methicillin-resistant Staphylococcus aureus (MRSA).
  • Optimal time for administration of pre- and intra-operative doses (for lengthy procedures).
  • Weight-based dosing for obese patients.
  • Common principles of antimicrobial prophylaxis for all types of surgical procedures.
  • Guidance specifically for surgery involving the small intestine, colon, rectum, cardiovascular system, and breast; as well as hernia repair and plastic surgery.

The guidelines are published in the February 1, 2013, edition of the American Journal of Health-System Pharmacy, and will also be published in the February edition of Surgical Infections. The document is available free online because of its potential to improve public health.

A poket guide representing key recommendations and dosing guides is available online and in print from International Guidelines Central.

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