Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Sartelli M, Boermeester MA, Cainzos M, Coccolini F, de Jonge SW, Rasa K, Dellinger EP, McNamara DA, Fry DE, Cui Y, Delibegovic S, Demetrashvili Z, De Simone B, Gkiokas G, Hardcastle TC, Itani KMF, Isik A, Labricciosa FM, Lohsiriwat V, Marwah S, Pintar T, Rickard J, Shelat VG, Catena F, Barie PS. Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery. Antibiotics (Basel) 2023;12:908. [PMID: 37237811 PMCID: PMC10215114 DOI: 10.3390/antibiotics12050908] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open

For:	Sartelli M, Boermeester MA, Cainzos M, Coccolini F, de Jonge SW, Rasa K, Dellinger EP, McNamara DA, Fry DE, Cui Y, Delibegovic S, Demetrashvili Z, De Simone B, Gkiokas G, Hardcastle TC, Itani KMF, Isik A, Labricciosa FM, Lohsiriwat V, Marwah S, Pintar T, Rickard J, Shelat VG, Catena F, Barie PS. Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery. Antibiotics (Basel) 2023;12:908. [PMID: 37237811 PMCID: PMC10215114 DOI: 10.3390/antibiotics12050908] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open

Number

Cited by Other Article(s)

Nokaneng EN, Holloway SL. A Clinical Audit of Surgical Site Infection Surveillance in a Maxillo-Facial and Oral Surgery Unit in an Academic Hospital Complex in South Africa. Int Wound J 2025;22:e70196. [PMID: 40289454 PMCID: PMC12034848 DOI: 10.1111/iwj.70196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 12/13/2024] [Accepted: 01/16/2025] [Indexed: 04/30/2025] Open

Rizzo CE, Venuto R, Tripodi P, Bartucciotto L, Ventura Spagnolo E, Nirta A, Genovese G, La Spina I, Sortino S, Nicita A, Loddo F, Romeo B, Squeri R, Genovese C. From Guidelines to Action: Tackling Risk Factors for Surgical Site Infections. Antibiotics (Basel) 2025;14:40. [PMID: 39858326 PMCID: PMC11763291 DOI: 10.3390/antibiotics14010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2024] [Revised: 12/30/2024] [Accepted: 01/03/2025] [Indexed: 01/27/2025] Open

Affiliation(s)

Caterina Elisabetta Rizzo Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.) Department of Prevention, Local Health Authority of Messina, 98123 Messina, Italy
Roberto Venuto Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.) Department of Prevention, Local Health Authority of Messina, 98123 Messina, Italy
Paola Tripodi Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.)
Linda Bartucciotto Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.)
Elvira Ventura Spagnolo Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.)
Antonio Nirta Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.)
Giovanni Genovese Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.) Department of Prevention, Local Health Authority of Messina, 98123 Messina, Italy
Isabella La Spina Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.) Department of Prevention, Local Health Authority of Messina, 98123 Messina, Italy
Sabrina Sortino Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.)
Alessandro Nicita Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.)
Francesco Loddo Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.)
Bruno Romeo Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.) Department of Prevention, Local Health Authority of Messina, 98123 Messina, Italy
Raffaele Squeri Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.)
Cristina Genovese Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; (P.T.); (L.B.); (E.V.S.); (A.N.); (G.G.); (I.L.S.); (S.S.); (A.N.); (F.L.); (B.R.); (R.S.); (C.G.)

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Zmora O, Fleshner P, Barie PS, Segev L, Viola GM, Senagore AJ, Spinelli A, Belotserkovsky O, Sharoni S, Emanuel N. Effect of local prolonged-release incisional doxycycline on surgical site infection prophylaxis in abdominal colorectal surgery: the SHIELD 1 randomized clinical trial. Int J Surg 2024;110:6658-6666. [PMID: 38869970 PMCID: PMC11486998 DOI: 10.1097/js9.0000000000001824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/24/2024] [Indexed: 06/15/2024]

Abstract

INTRODUCTION

Despite advanced infection control practices including preoperative antibiotic prophylaxis, surgical site infection (SSI) remains a challenge. This study aimed to test whether local administration of a novel prolonged-release doxycycline-polymer-lipid encapsulation matrix (D-PLEX) before wound closure, concomitantly with standard of care (SOC), reduces the incidence of incisional SSI after elective abdominal colorectal surgery.

MATERIALS AND METHODS

This was a phase 3 randomized, controlled, double-blind, multinational study (SHIELD 1) between June 2020 to June 2022. Patients with at least one abdominal incision length greater than 10 cm were randomized 1:1 to the investigational arm (D-PLEX+SOC) or control (SOC) arm. The primary outcome was a composite of incisional SSI, incisional reintervention, and all-cause mortality.

RESULTS

A total of 974 patients were analyzed, of whom 579 (59.4%) were male. The mean age (±SD) was 64.2±13.0 years. The primary outcome occurred in 9.3% of D-PLEX patients versus 12.1% (SOC) [risk difference estimate (RDE), -2.8%; 95% CI (-6.7%, 1.0%), P =0.1520]. In a pre-specified analysis by incision length, a reduction in the primary outcome was observed in the greater than 20 cm subpopulation: 8% (D-PLEX) versus 17.5% (SOC) [RDE, -9.4%; 95% CI (-15.5%, -3.2%), P =0.0032]. In the greater than 10 to less than or equal to 20 cm subgroup, no reduction was observed: 9.9% versus 7.9% [RDE, 2.0%; 95% CI (-2.8%, 6.7%), P =0.4133]. Exploratory post hoc analyses of patients with increased SSI risk (≥1 patient-specific comorbidity) indicated a reduction in the incidence of the primary outcome: 9.0% (D-PLEX) versus 13.7% (SOC) [RDE, -4.8%; 95% CI (-9.5%, -0.1%), P =0.0472]. The D-PLEX safety profile was good (no difference in treatment-emergent adverse events between the groups).

CONCLUSIONS

The SHIELD 1 study did not meet its primary outcome of reduced incisional SSI, incisional reinterventions, or all-cause mortality. Pre-specified and post hoc analyses suggested that D-PLEX may reduce the incidence of the primary outcome event in patients with increased SSI risk, including lengthy incisions.

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Mengesha MG, Rajasekaran S, Ramachandran K, Sengodan VC, Yasin NF, Williams LM, Laubscher M, Watanabe K, Dastagir O, Akinmadr A, Fisseha HK, Aziz A, Yurac R, Gebrehana E, AlSaifi M, Pathinathan K, Sudhir G, Shokri AA, Chan Kim Y, Jonayed SA, Kido GR, Ignacio JM, Mohammed MS, Abubakar K, Hakim J, Duwal Shrestha SK, Al Mamun Choudhury A, Diallo M, Molina M, Patwardhan S, Hai Y, Ramat AM, Kawai M, Cho JH, Shah Kalawar RP, Choi SW, Zarate-Kalfopulos B, Guiroy A, Astur N, Buunaaim A, Human AL, Zaman AU. Orthopedic postoperative infection profile and antibiotic sensitivity of 2038 patients across 24 countries - Call for region and institution specific surgical antimicrobial prophylaxis. J Orthop 2024;55:97-104. [PMID: 38681829 PMCID: PMC11047196 DOI: 10.1016/j.jor.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 04/14/2024] [Indexed: 05/01/2024] Open

Abstract

Purpose

Improper utilization of surgical antimicrobial prophylaxis frequently leads to increased risks of morbidity and mortality.This study aims to understand the common causative organism of postoperative orthopedic infection and document the surgical antimicrobial prophylaxis protocol across various institutions in to order to strengthen surgical antimicrobial prophylaxis practice and provide higher-quality surgical care.

Methods

This multicentric multinational retrospective study, includes 24 countries from five different regions (Asia Pacific, South Eastern Africa, Western Africa, Latin America, and Middle East). Patients who developed orthopedic surgical site infection between January 2021 and December 2022 were included. Demographic details, bacterial profile of surgical site infection, and antibiotic sensitivity pattern were documented.

Results

2038 patients from 24 countries were included. Among them 69.7 % were male patients and 64.1 % were between 20 and 60 years. 70.3 % patients underwent trauma surgery and instrumentation was used in 93.5 %. Ceftriaxone was the most common preferred in 53.4 %. Early SSI was seen in 55.2 % and deep SSI in 59.7 %. Western Africa (76 %) and Asia-Pacific (52.8 %) reported a higher number of gram-negative infections whereas gram-positive organisms were predominant in other regions. Most common gram positive organism was Staphylococcus aureus (35 %) and gram-negative was Klebsiella (17.2 %). Majority of the organisms showed variable sensitivity to broad-spectrum antibiotics.

Conclusion

Our study strongly proves that every institution has to analyse their surgical site infection microbiological profile and antibiotic sensitivity of the organisms and plan their surgical antimicrobial prophylaxis accordingly. This will help to decrease the rate of surgical site infection, prevent the emergence of multidrug resistance and reduce the economic burden of treatment.

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Affiliation(s)

Mengistu G. Mengesha Hawassa University College of Medicine and Health Sciences, Ethiopia
Shanmuganathan Rajasekaran Department of Orthopedics and Spine Surgery, Ganga Medical Centre and Hospital Pvt. Ltd., Mettupalayam Road, Coimbatore, India
Karthik Ramachandran Department of Orthopedics and Spine Surgery, Ganga Medical Centre and Hospital Pvt. Ltd., Mettupalayam Road, Coimbatore, India
Vetrivel Chezian Sengodan Institute of Orthopaedics and Traumatology, Coimbatore Medical College, Tamilnadu, India
Nor Faissal Yasin Natioal Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Orthopaedic Surgery Department, Faculty of Medicine, Universiti Malaya, Malaysia
Luke Michael Williams University Hospitals Bristol & Weston NHS, United Kingdom
Maritz Laubscher Orthopaedic Research Unit (ORU), University of Cape Town, South Africa
Kota Watanabe Department of Orthopaedic Surgery, Keio University School of Medicine, Japan
O.Z.M. Dastagir National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh
Akinola Akinmadr Afe Babalola University, Ado-Ekiti, Nigeria
Hizkyas K. Fisseha Hawassa University College of Medicine and Health Sciences, Ethiopia
Amer Aziz Orthopaedic & Spine Unit at Lahore Medical & Dental College / Ghurki Trust Teaching Hospital, Lahore, Pakistan
Ratko Yurac Department of Orthopedics and Traumatology, Universidad Del Desarrollo (UDD). Clinica Alemana de Santiago, Chile
Ephrem Gebrehana Hawassa University College of Medicine and Health Sciences, Ethiopia
Mohammed AlSaifi University for Medicine and Applied Sciences, Yemen
Kalaventhan Pathinathan National Hospital-Colombo, Sri Lanka
G. Sudhir Sri Ramachandra Institute of Higher Education and Research, India
Amran Ahmed Shokri Universiti Sains Malaysia, Malaysia
Yong Chan Kim Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seol, South Korea
Sharif Ahmed Jonayed National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh
Gonzalo R. Kido Orthopaedic and Traumatology Department, Institute of Orthopedics â€œCarlos E. Ottolenghiâ€, Hospital Italiano de Buenos Aires, Argentina
Jose Manuel Ignacio Department of Orthopedics, University of the Philippines Manila, Manila, Philippines
Matiyas Seid Mohammed Hosaena University Hospital, Ethiopia
Kabir Abubakar National Orthopaedic Hospital, Dala, Kano, Nigeria
Jonaed Hakim BIRDEM General Hospital & Ibrahim Medical College, Bangladesh
Sailendra Kumar Duwal Shrestha Nepal Armed Police Force Hospital, Nepal
Abdullah Al Mamun Choudhury National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh
Malick Diallo Universite NAZI BONI, Burkina Faso
Marcelo Molina Instituto TraumatolÃ³gico de Santiago, Universidad Finis Terrae, Chile
Sandeep Patwardhan Dept. of Orthopaedics, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, Maharashtra, India
Yong Hai Beijing Chaoyang Hospital, Capital Medical University, China
Ali M. Ramat University of Maiduguri Teaching Hospital, Nigeria
Momotaro Kawai Department of Orthopaedic Surgery, Spine Center, Kitasato Institute Hospital, Japan
Jae Hwan Cho University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
Rosan Prasad Shah Kalawar Nepal Armed Police Force Hospital, Nepal
Sung-Woo Choi Department of Orthopaedic Surgery, Soonchunhyang University College of Medicine, Seoul, South Korea
Baron Zarate-Kalfopulos Instituto Nacional de Rehabilitacion, Mexico
Alfredo Guiroy ClÃ-nica de Cuyo, Mendoza, Argentina
Nelson Astur Hospital Israelita Albert Einstein, Sao Paulo, Brazil
AlexisD.B. Buunaaim University for Development Studies, Ghana
Anton L. Human University of Cape Town, South Korea
Atiq Uz Zaman Ghurki Trust Teaching Hospital/Lahore Medical and Dental College, Pakistan

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Wei D, Zheng Y, Bi L. Is Antibiotic Prophylaxis Reasonable in Parotid Surgery? Retrospective Analysis of Surgical Site Infection. Surg Infect (Larchmt) 2024;25:521-526. [PMID: 38957972 DOI: 10.1089/sur.2024.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open

Abstract

Background: The prophylactic use of antibiotics in parotid region surgery continues to be a subject of debate. The aim of this study is to elucidate the impact of antibiotic prophylaxis on surgical site infections (SSIs) in parotid region surgery. Patients and Methods: Patients who received antibiotic prophylaxis during the peri-operative period were designated as group 1, whereas those who did not were categorized into group 2. Group 1 cases were further subdivided into three subgroups based on different antibiotic usage patterns. Patient individual information was collected. Clinical data such as surgical duration, post-operative hospital stay, incision infection status, and antibiotic usage were recorded. All data were compared and analyzed among different groups. Results: A total of 357 patients were included in the study, with no statistically significant differences in baseline characteristics. Pre-operative American Society of Anesthesiologists scores did not significantly differ between groups (p = 0.151), but there was a significant distinction in National Nosocomial Infection Surveillance (NNIS) index values (p = 0.044). Furthermore, surgical duration (p = 0.001) and pathology types (p = 0.016) differed significantly. The post-operative hospital stay in group 1 was longer than that in group 2 (p < 0.01). The post-operative SSI rate in group 1 was lower than that in group 2 without statistical significance (2.55% vs. 5.59%, p = 0.141). The logistic regression analysis showed that malignant tumors, longer surgical durations, and higher NNIS index scores correlated positively with post-operative SSI rates. Meanwhile, compared with non-use, all three different antibiotic use modes correlated negatively with SSI occurrence. Conclusions: Antibiotic prophylaxis in parotid gland surgery shows no significant reduction in SSI occurrence. If there is a compelling reason to administer prophylactic antibiotics, pre-operative single dose may be a relatively feasible measure for preventing SSIs.

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De Simone B, Chouillard E, Podda M, Pararas N, de Carvalho Duarte G, Fugazzola P, Birindelli A, Coccolini F, Polistena A, Sibilla MG, Kruger V, Fraga GP, Montori G, Russo E, Pintar T, Ansaloni L, Avenia N, Di Saverio S, Leppäniemi A, Lauretta A, Sartelli M, Puzziello A, Carcoforo P, Agnoletti V, Bissoni L, Isik A, Kluger Y, Moore EE, Romeo OM, Abu-Zidan FM, Beka SG, Weber DG, Tan ECTH, Paolillo C, Cui Y, Kim F, Picetti E, Di Carlo I, Toro A, Sganga G, Sganga F, Testini M, Di Meo G, Kirkpatrick AW, Marzi I, déAngelis N, Kelly MD, Wani I, Sakakushev B, Bala M, Bonavina L, Galante JM, Shelat VG, Cobianchi L, Mas FD, Pikoulis M, Damaskos D, Coimbra R, Dhesi J, Hoffman MR, Stahel PF, Maier RV, Litvin A, Latifi R, Biffl WL, Catena F. The 2023 WSES guidelines on the management of trauma in elderly and frail patients. World J Emerg Surg 2024;19:18. [PMID: 38816766 PMCID: PMC11140935 DOI: 10.1186/s13017-024-00537-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/26/2024] [Indexed: 06/01/2024] Open

Abstract

BACKGROUND

The trauma mortality rate is higher in the elderly compared with younger patients. Ageing is associated with physiological changes in multiple systems and correlated with frailty. Frailty is a risk factor for mortality in elderly trauma patients. We aim to provide evidence-based guidelines for the management of geriatric trauma patients to improve it and reduce futile procedures.

METHODS

Six working groups of expert acute care and trauma surgeons reviewed extensively the literature according to the topic and the PICO question assigned. Statements and recommendations were assessed according to the GRADE methodology and approved by a consensus of experts in the field at the 10th international congress of the WSES in 2023.

RESULTS

The management of elderly trauma patients requires knowledge of ageing physiology, a focused triage, including drug history, frailty assessment, nutritional status, and early activation of trauma protocol to improve outcomes. Acute trauma pain in the elderly has to be managed in a multimodal analgesic approach, to avoid side effects of opioid use. Antibiotic prophylaxis is recommended in penetrating (abdominal, thoracic) trauma, in severely burned and in open fractures elderly patients to decrease septic complications. Antibiotics are not recommended in blunt trauma in the absence of signs of sepsis and septic shock. Venous thromboembolism prophylaxis with LMWH or UFH should be administrated as soon as possible in high and moderate-risk elderly trauma patients according to the renal function, weight of the patient and bleeding risk. A palliative care team should be involved as soon as possible to discuss the end of life in a multidisciplinary approach considering the patient's directives, family feelings and representatives' desires, and all decisions should be shared.

CONCLUSIONS

The management of elderly trauma patients requires knowledge of ageing physiology, a focused triage based on assessing frailty and early activation of trauma protocol to improve outcomes. Geriatric Intensive Care Units are needed to care for elderly and frail trauma patients in a multidisciplinary approach to decrease mortality and improve outcomes.

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Affiliation(s)

Belinda De Simone Department of Emergency Minimally Invasive Surgery, Academic Hospital of Villeneuve St Georges, Villeneuve St Georges, France. Department of General Minimally Invasive Surgery, Infermi Hospital, AUSL Romagna, Rimini, Italy. General Surgery Department, American Hospital of Paris, Paris, France.
Elie Chouillard General Surgery Department, American Hospital of Paris, Paris, France
Mauro Podda Department of Surgical Science, Unit of Emergency Surgery, University of Cagliari, Cagliari, Italy
Nikolaos Pararas 3rd Department of Surgery, Attikon General Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece
Gustavo de Carvalho Duarte New Zealand Blood Service, Christchurch, New Zealand
Paola Fugazzola Unit of General Surgery I, IRCCS San Matteo Hospital of Pavia, University of Pavia, Pavia, Italy
Arianna Birindelli Unit of General Surgery, Esine Hospital, ASST Valcamonica, Esine, Italy
Federico Coccolini Department of General Surgery, University Hospital of Pisa, Pisa, Italy
Andrea Polistena Department of Surgery, Policlinico Umberto I Roma, Sapienza University, Rome, Italy
Maria Grazia Sibilla Department of Surgery, Unit of General Surgery, University Hospital of Ferrara and University of Ferrara, Ferrara, Italy
Vitor Kruger Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, Brazil
Gustavo P Fraga Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, Brazil
Giulia Montori Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Via C. Forlanini 71, 31029, Vittorio Veneto, TV, Italy
Emanuele Russo Department of Anesthesia, Level I, Trauma Center, Bufalini Hospital, Cesena, Italy
Tadeja Pintar UMC Ljubljana and Medical Faculty Ljubljana, Ljubljana, Slovenia
Luca Ansaloni New Zealand Blood Service, Christchurch, New Zealand
Nicola Avenia Endocrine Surgical Unit - University of Perugia, Terni, Italy
Salomone Di Saverio General Surgery Unit, Madonna del Soccorso Hospital, AST Ascoli Piceno, San Benedetto del Tronto, Italy
Ari Leppäniemi Division of Emergency Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Andrea Lauretta Department of Surgical Oncology, Centro Di Riferimento Oncologico Di Aviano IRCCS, Aviano, Italy
Massimo Sartelli Department of General Surgery, Macerata Hospital, Macerata, Italy
Alessandro Puzziello Dipartimento di Medicina, Chirurgia e Odontoiatria, Campus Universitario di Baronissi (SA) - Università di Salerno, AOU San Giovanni di Dio e Ruggi di Aragona, Salerno, Italy
Paolo Carcoforo Department of Surgery, Unit of General Surgery, University Hospital of Ferrara and University of Ferrara, Ferrara, Italy
Vanni Agnoletti Department of Anesthesia, Level I, Trauma Center, Bufalini Hospital, Cesena, Italy
Luca Bissoni Department of Anesthesia, Level I, Trauma Center, Bufalini Hospital, Cesena, Italy
Arda Isik Istanbul Medeniyet University, Istanbul, Turkey
Yoram Kluger Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
Ernest E Moore Ernest E Moore Shock Trauma Center at Denver Health, University of Colorado, Denver, CO, USA
Oreste Marco Romeo Bronson Methodist Hospital/Western Michigan University, Kalamazoo, MI, USA
Fikri M Abu-Zidan Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al‑Ain, United Arab Emirates
Solomon Gurmu Beka Ethiopian Air Force Hospital, Bishoftu, Oromia, Ethiopia
Dieter G Weber Department of General Surgery, Royal Perth Hospital and The University of Western Australia, Perth, Australia
Edward C T H Tan Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
Ciro Paolillo Emergency Department, Ospedale Civile Maggiore, Verona, Italy
Yunfeng Cui Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
Fernando Kim University of Colorado Anschutz Medical Campus, Denver, CO, 80246, USA
Edoardo Picetti Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy
Isidoro Di Carlo Department of Surgical Sciences and Advanced Technologies, General Surgery Cannizzaro Hospital, University of Catania, Catania, Italy
Adriana Toro Department of Surgical Sciences and Advanced Technologies, General Surgery Cannizzaro Hospital, University of Catania, Catania, Italy
Gabriele Sganga Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, Rome, Italy
Federica Sganga Department of Geriatrics, Ospedale Sant'Anna, Ferrara, Italy
Mario Testini Department of Precision and Regenerative Medicine and Ionian Area, Unit of Academic General Surgery, University of Bari "A. Moro", Bari, Italy
Giovanna Di Meo Department of Precision and Regenerative Medicine and Ionian Area, Unit of Academic General Surgery, University of Bari "A. Moro", Bari, Italy
Andrew W Kirkpatrick Departments of Surgery and Critical Care Medicine, University of Calgary, Foothills Medical Centre, Calgary, AB, Canada
Ingo Marzi Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
Nicola déAngelis Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, France
Michael Denis Kelly Department of General Surgery, MedAlliance, Albury, NSW, Australia
Imtiaz Wani Department of Surgery, Government Gousia Hospital, DHS, Srinagar, India
Boris Sakakushev General Surgery Department, Medical University, University Hospital St George, Plovdiv, Bulgaria
Miklosh Bala Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
Luigi Bonavina Division of General Surgery, IRCCS Policlinico San Donato, University of Milan, Milan, Italy
Joseph M Galante Division of Trauma and Acute Care Surgery, Department of Surgery, University of California Davis, Sacramento, CA, USA
Vishal G Shelat Department of General Surgery, Tan Tock Seng Hospital, Novena, Singapore
Lorenzo Cobianchi Unit of General Surgery I, IRCCS San Matteo Hospital of Pavia, University of Pavia, Pavia, Italy Collegium Medicum, University of Social Sciences, Łodz, Poland
Francesca Dal Mas Department of Management, Ca' Foscari University of Venice, Venice, Italy Collegium Medicum, University of Social Sciences, Łodz, Poland
Manos Pikoulis Department of Surgical Science, Unit of Emergency Surgery, University of Cagliari, Cagliari, Italy
Dimitrios Damaskos Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
Raul Coimbra Riverside University Health System Medical Center, Riverside, CA, USA
Jugdeep Dhesi Guy's and St Thomas' NHS Foundation Trust, London, UK
Melissa Red Hoffman Department of Surgery, University of North Carolina, Surgical Palliative Care Society, Asheville, NC, USA
Philip F Stahel Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC, USA
Ronald V Maier Harborview Medical Center, University of Washington, Seattle, WA, USA
Andrey Litvin Department of Surgical Diseases No. 3, Gomel State Medical University, University Clinic, Gomel, Belarus
Rifat Latifi University of Arizona, Tucson, AZ, USA Abrazo Health West Campus, Goodyear, Tucson, AZ, USA
Walter L Biffl Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA
Fausto Catena Department of General and Emergency Surgery, Bufalini Hospital-Level 1 Trauma Center, AUSL Romagna, Cesena, Italy

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Sartelli M, Coccolini F, Labricciosa FM, Al Omari AH, Bains L, Baraket O, Catarci M, Cui Y, Ferreres AR, Gkiokas G, Gomes CA, Hodonou AM, Isik A, Litvin A, Lohsiriwat V, Kotecha V, Khokha V, Kryvoruchko IA, Machain GM, O’Connor DB, Olaoye I, Al-Omari JAK, Pasculli A, Petrone P, Rickard J, Sall I, Sawyer RG, Téllez-Almenares O, Catena F, Siquini W. Surgical Antibiotic Prophylaxis: A Proposal for a Global Evidence-Based Bundle. Antibiotics (Basel) 2024;13:100. [PMID: 38275329 PMCID: PMC10812782 DOI: 10.3390/antibiotics13010100] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/03/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open

Abstract

In the multimodal strategy context, to implement healthcare-associated infection prevention, bundles are one of the most commonly used methods to adapt guidelines in the local context and transfer best practices into routine clinical care. One of the most important measures to prevent surgical site infections is surgical antibiotic prophylaxis (SAP). This narrative review aims to present a bundle for the correct SAP administration and evaluate the evidence supporting it. Surgical site infection (SSI) prevention guidelines published by the WHO, CDC, NICE, and SHEA/IDSA/APIC/AHA, and the clinical practice guidelines for SAP by ASHP/IDSA/SIS/SHEA, were reviewed. Subsequently, comprehensive searches were also conducted using the PubMed®/MEDLINE and Google Scholar databases, in order to identify further supporting evidence-based documentation. The bundle includes five different measures that may affect proper SAP administration. The measures included may be easily implemented in all hospitals worldwide and are based on minimal drug pharmacokinetics and pharmacodynamics knowledge, which all surgeons should know. Antibiotics for SAP should be prescribed for surgical procedures at high risk for SSIs, such as clean-contaminated and contaminated surgical procedures or for clean surgical procedures where SSIs, even if unlikely, may have devastating consequences, such as in procedures with prosthetic implants. SAP should generally be administered within 60 min before the surgical incision for most antibiotics (including cefazolin). SAP redosing is indicated for surgical procedures exceeding two antibiotic half-lives or for procedures significantly associated with blood loss. In principle, SAP should be discontinued after the surgical procedure. Hospital-based antimicrobial stewardship programmes can optimise the treatment of infections and reduce adverse events associated with antibiotics. In the context of a collaborative and interdisciplinary approach, it is essential to encourage an institutional safety culture in which surgeons are persuaded, rather than compelled, to respect antibiotic prescribing practices. In that context, the proposed bundle contains a set of evidence-based interventions for SAP administration. It is easy to apply, promotes collaboration, and includes measures that can be adequately followed and evaluated in all hospitals worldwide.

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Affiliation(s)

Massimo Sartelli Department of Surgery, Macerata Hospital, 62100 Macerata, Italy;
Federico Coccolini General, Emergency and Trauma Surgery Unit, Pisa University Hospital, 56124 Pisa, Italy;
Francesco M. Labricciosa Global Alliance for Infections in Surgery, 62100 Macerata, Italy;
AbdelKarim. H. Al Omari Department of General Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan;
Lovenish Bains Department of General Surgery, Maulana Azad Medical College, New Delhi 110002, India;
Oussama Baraket Department of General Surgery, Bizerte Hospital, Bizerte 7000, Tunisia;
Marco Catarci General Surgery Unit, Sandro Pertini Hospital, 00157 Rome, Italy;
Yunfeng Cui Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin 300052, China;
Alberto R. Ferreres Department of Surgery, University of Buenos Aires, Buenos Aires 1428, Argentina;
George Gkiokas Department of Surgery, Medical School, “Aretaieio” Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
Carlos Augusto Gomes Department of Surgery, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Hospital Universitário Terezinha de Jesus, Juiz de Fora 25520, Brazil;
Adrien M. Hodonou Department of Surgery, Faculty of Medicine, University of Parakou, Parakou 03 BP 10, Benin;
Arda Isik Department of Surgery, Istanbul Medeniyet University, Istanbul 34000, Turkey;
Andrey Litvin Department of Surgical Diseases No. 3, Gomel State Medical University, 246000 Gomel, Belarus;
Varut Lohsiriwat Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
Vihar Kotecha Department of General Surgery, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
Vladimir Khokha General Surgery Unit, Podhalanski Specialized Hospital, 34-400 Nowy Targ, Poland;
Igor A. Kryvoruchko Department of Surgery No. 2, Kharkiv National Medical University, 61000 Kharkiv, Ukraine;
Gustavo M. Machain Department of Surgery, Universidad Nacional de Asuncion, San Lorenzo 1055, Paraguay;
Donal B. O’Connor Department of Surgery, School of Medicine, Trinity College, D02 PN40 Dublin, Ireland;
Iyiade Olaoye Department of Surgery, University of Ilorin Teaching Hospital, Ilorin 240101, Nigeria;
Jamal A. K. Al-Omari Medical College, Al-Balqa Applied University, Al-Hussein Hospital, Zarqa 13313, Jordan;
Alessandro Pasculli Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Unit of Academic General Surgery “V. Bonomo”, University of Bari “A. Moro”, 70125 Bari, Italy;
Patrizio Petrone Department of Surgery, NYU Grossman Long Island School of Medicine, NYU Langone Hospital—Long Island, Mineola, NY 11501, USA;
Jennifer Rickard Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA;
Ibrahima Sall Department of General Surgery, Military Teaching Hospital, Dakar 3006, Senegal;
Robert G. Sawyer Department of Surgery, School of Medicine, Western Michigan University, Kalamazoo, MI 49008, USA;
Orlando Téllez-Almenares General Surgery Department of Saturnino Lora Provincial Hospital, University of Medical Sciences of Santiago de Cuba, 26P2+J7X, Santiago de Cuba 90100, Cuba;
Fausto Catena Department of Surgery, “Bufalini” Hospital, 47521 Cesena, Italy;
Walter Siquini Department of Surgery, Macerata Hospital, 62100 Macerata, Italy;

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Zelenitsky SA. Effective Antimicrobial Prophylaxis in Surgery: The Relevance and Role of Pharmacokinetics-Pharmacodynamics. Antibiotics (Basel) 2023;12:1738. [PMID: 38136772 PMCID: PMC10741006 DOI: 10.3390/antibiotics12121738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open

Sartelli M, Barie PS, Coccolini F, Abbas M, Abbo LM, Abdukhalilova GK, Abraham Y, Abubakar S, Abu-Zidan FM, Adebisi YA, Adamou H, Afandiyeva G, Agastra E, Alfouzan WA, Al-Hasan MN, Ali S, Ali SM, Allaw F, Allwell-Brown G, Amir A, Amponsah OKO, Al Omari A, Ansaloni L, Ansari S, Arauz AB, Augustin G, Awazi B, Azfar M, Bah MSB, Bala M, Banagala ASK, Baral S, Bassetti M, Bavestrello L, Beilman G, Bekele K, Benboubker M, Beović B, Bergamasco MD, Bertagnolio S, Biffl WL, Blot S, Boermeester MA, Bonomo RA, Brink A, Brusaferro S, Butemba J, Caínzos MA, Camacho-Ortiz A, Canton R, Cascio A, Cassini A, Cástro-Sanchez E, Catarci M, Catena R, Chamani-Tabriz L, Chandy SJ, Charani E, Cheadle WG, Chebet D, Chikowe I, Chiara F, Cheng VCC, Chioti A, Cocuz ME, Coimbra R, Cortese F, Cui Y, Czepiel J, Dasic M, de Francisco Serpa N, de Jonge SW, Delibegovic S, Dellinger EP, Demetrashvili Z, De Palma A, De Silva D, De Simone B, De Waele J, Dhingra S, Diaz JJ, Dima C, Dirani N, Dodoo CC, Dorj G, Duane TM, Eckmann C, Egyir B, Elmangory MM, Enani MA, Ergonul O, Escalera-Antezana JP, Escandon K, Ettu AWOO, Fadare JO, Fantoni M, Farahbakhsh M, Faro MP, Ferreres A, Flocco G, et alSartelli M, Barie PS, Coccolini F, Abbas M, Abbo LM, Abdukhalilova GK, Abraham Y, Abubakar S, Abu-Zidan FM, Adebisi YA, Adamou H, Afandiyeva G, Agastra E, Alfouzan WA, Al-Hasan MN, Ali S, Ali SM, Allaw F, Allwell-Brown G, Amir A, Amponsah OKO, Al Omari A, Ansaloni L, Ansari S, Arauz AB, Augustin G, Awazi B, Azfar M, Bah MSB, Bala M, Banagala ASK, Baral S, Bassetti M, Bavestrello L, Beilman G, Bekele K, Benboubker M, Beović B, Bergamasco MD, Bertagnolio S, Biffl WL, Blot S, Boermeester MA, Bonomo RA, Brink A, Brusaferro S, Butemba J, Caínzos MA, Camacho-Ortiz A, Canton R, Cascio A, Cassini A, Cástro-Sanchez E, Catarci M, Catena R, Chamani-Tabriz L, Chandy SJ, Charani E, Cheadle WG, Chebet D, Chikowe I, Chiara F, Cheng VCC, Chioti A, Cocuz ME, Coimbra R, Cortese F, Cui Y, Czepiel J, Dasic M, de Francisco Serpa N, de Jonge SW, Delibegovic S, Dellinger EP, Demetrashvili Z, De Palma A, De Silva D, De Simone B, De Waele J, Dhingra S, Diaz JJ, Dima C, Dirani N, Dodoo CC, Dorj G, Duane TM, Eckmann C, Egyir B, Elmangory MM, Enani MA, Ergonul O, Escalera-Antezana JP, Escandon K, Ettu AWOO, Fadare JO, Fantoni M, Farahbakhsh M, Faro MP, Ferreres A, Flocco G, Foianini E, Fry DE, Garcia AF, Gerardi C, Ghannam W, Giamarellou H, Glushkova N, Gkiokas G, Goff DA, Gomi H, Gottfredsson M, Griffiths EA, Guerra Gronerth RI, Guirao X, Gupta YK, Halle-Ekane G, Hansen S, Haque M, Hardcastle TC, Hayman DTS, Hecker A, Hell M, Ho VP, Hodonou AM, Isik A, Islam S, Itani KMF, Jaidane N, Jammer I, Jenkins DR, Kamara IF, Kanj SS, Jumbam D, Keikha M, Khanna AK, Khanna S, Kapoor G, Kapoor G, Kariuki S, Khamis F, Khokha V, Kiggundu R, Kiguba R, Kim HB, Kim PK, Kirkpatrick AW, Kluger Y, Ko WC, Kok KYY, Kotecha V, Kouma I, Kovacevic B, Krasniqi J, Krutova M, Kryvoruchko I, Kullar R, Labi KA, Labricciosa FM, Lakoh S, Lakatos B, Lansang MAD, Laxminarayan R, Lee YR, Leone M, Leppaniemi A, Hara GL, Litvin A, Lohsiriwat V, Machain GM, Mahomoodally F, Maier RV, Majumder MAA, Malama S, Manasa J, Manchanda V, Manzano-Nunez R, Martínez-Martínez L, Martin-Loeches I, Marwah S, Maseda E, Mathewos M, Maves RC, McNamara D, Memish Z, Mertz D, Mishra SK, Montravers P, Moro ML, Mossialos E, Motta F, Mudenda S, Mugabi P, Mugisha MJM, Mylonakis E, Napolitano LM, Nathwani D, Nkamba L, Nsutebu EF, O’Connor DB, Ogunsola S, Jensen PØ, Ordoñez JM, Ordoñez CA, Ottolino P, Ouedraogo AS, Paiva JA, Palmieri M, Pan A, Pant N, Panyko A, Paolillo C, Patel J, Pea F, Petrone P, Petrosillo N, Pintar T, Plaudis H, Podda M, Ponce-de-Leon A, Powell SL, Puello-Guerrero A, Pulcini C, Rasa K, Regimbeau JM, Rello J, Retamozo-Palacios MR, Reynolds-Campbell G, Ribeiro J, Rickard J, Rocha-Pereira N, Rosenthal VD, Rossolini GM, Rwegerera GM, Rwigamba M, Sabbatucci M, Saladžinskas Ž, Salama RE, Sali T, Salile SS, Sall I, Kafil HS, Sakakushev BE, Sawyer RG, Scatizzi M, Seni J, Septimus EJ, Sganga G, Shabanzadeh DM, Shelat VG, Shibabaw A, Somville F, Souf S, Stefani S, Tacconelli E, Tan BK, Tattevin P, Rodriguez-Taveras C, Telles JP, Téllez-Almenares O, Tessier J, Thang NT, Timmermann C, Timsit JF, Tochie JN, Tolonen M, Trueba G, Tsioutis C, Tumietto F, Tuon FF, Ulrych J, Uranues S, van Dongen M, van Goor H, Velmahos GC, Vereczkei A, Viaggi B, Viale P, Vila J, Voss A, Vraneš J, Watkins RR, Wanjiru-Korir N, Waworuntu O, Wechsler-Fördös A, Yadgarova K, Yahaya M, Yahya AI, Xiao Y, Zakaria AD, Zakrison TL, Zamora Mesia V, Siquini W, Darzi A, Pagani L, Catena F. Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action. World J Emerg Surg 2023;18:50. [PMID: 37845673 PMCID: PMC10580644 DOI: 10.1186/s13017-023-00518-3] [Show More Authors] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/23/2023] [Indexed: 10/18/2023] Open

Dhole S, Mahakalkar C, Kshirsagar S, Bhargava A. Antibiotic Prophylaxis in Surgery: Current Insights and Future Directions for Surgical Site Infection Prevention. Cureus 2023;15:e47858. [PMID: 38021553 PMCID: PMC10680052 DOI: 10.7759/cureus.47858] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/28/2023] [Indexed: 12/01/2023] Open

Abstract

Surgical site infections (SSIs) remain a significant concern in the field of surgery, contributing to patient morbidity, prolonged hospital stays, and increased healthcare costs. Antibiotic prophylaxis, the administration of antibiotics before surgery, has been a cornerstone in preventing SSIs for decades. This review explores the current state of antibiotic prophylaxis in surgery, offering insights into its effectiveness, challenges, and emerging trends. In this comprehensive analysis, we delve into the historical development of antibiotic prophylaxis, examining its evolution from early practices to modern guidelines. We explore the various classes of antibiotics commonly used, their dosing regimens, and the importance of timing in optimizing prophylactic interventions. Additionally, we investigate the role of patient-specific factors, such as comorbidities and allergies, in tailoring antibiotic prophylaxis to individual needs. While antibiotic prophylaxis has undeniably reduced the incidence of SSIs, concerns about antimicrobial resistance and adverse effects necessitate a reevaluation of current practices. This review presents a critical assessment of the challenges posed by the overuse and misuse of antibiotics in surgery and highlights the urgent need for judicious antibiotic stewardship. Moreover, the future of antibiotic prophylaxis holds promise with the emergence of innovative strategies such as antimicrobial coatings, probiotics, and immunomodulatory agents. We discuss these novel approaches and their potential to enhance SSI prevention while minimizing antibiotic-related risks. In conclusion, antibiotic prophylaxis in surgery has been instrumental in reducing SSIs, but its continued effectiveness requires a multifaceted approach. By addressing current challenges, promoting antibiotic stewardship, and embracing innovative strategies, we can advance the field of SSI prevention and improve patient outcomes in the years to come. This review provides valuable insights and direction for clinicians, researchers, and policymakers as they navigate the evolving landscape of surgical prophylaxis.

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Kim HG, Lee HK, Park E. Abdominal Actinomycotic Abscess after Laparoscopic Sleeve Gastrectomy for Morbid Obesity: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023;59:1516. [PMID: 37763634 PMCID: PMC10534873 DOI: 10.3390/medicina59091516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/11/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023]