Fulltext

Perioperative Antibiotic Prophylaxis of Wound and Foreign Body Infections: Microbial Factors Affecting Efficacy

Waldvogel, F. A. ; Vaudaux, P. E. ; Pittet, D. ; Lew, P. D.

In: Reviews of Infectious Diseases, 1991, vol. 13, no. Supplement_10, p. S782-S789

Add to personal list
    Title
    • Perioperative Antibiotic Prophylaxis of Wound and Foreign Body Infections: Microbial Factors Affecting Efficacy
    Author
    • Waldvogel, F. A.. Infectious Disease Division and the Clinique Médicale Thérapeutique, University Hospital, Geneva, Switzerland
    • Vaudaux, P. E.. Infectious Disease Division and the Clinique Médicale Thérapeutique, University Hospital, Geneva, Switzerland
    • Pittet, D.. Infectious Disease Division and the Clinique Médicale Thérapeutique, University Hospital, Geneva, Switzerland
    • Lew, P. D.. Infectious Disease Division and the Clinique Médicale Thérapeutique, University Hospital, Geneva, Switzerland
    Document Type
    • Postprint
    Classification
    • Health
    OAI-PMH Identifier
    • oai:doc.rero.ch:295672
    Summary
    Numerous microbial factors are responsible for perioperative infections and influence the efficacy of antibiotic prophylaxis. These factors include the staphylococcal carrier state, bacterial adherence to a number of host proteins, the production of glycocalyx by sessile bacteria, and shifts in antibiotic resistance. A full understanding of the mechanisms involved will lead to further reductions in the number of postoperative infections. Unfortunately, the microbial factors affecting prophylaxis cannot be evaluated separately under clinical conditions; they are easier to study under circumstances whose bacteriologic features are well defined and in which the presence of foreign materials (e.g., sutures) greatly potentiates pathogenic mechanisms. Such circumstances exist, for example, in infections developing after "clean” surgery and in experimental models. Since even clean wounds are found to be contaminated when sampled carefully, the control of infection is more a quantitative than a qualitative problem. The critical period for the development of infection is short: an antibiotic course not exceeding 24 hours seems effective in preventing infection