Question

how does a surgeon know what antibiotic to prescribe for prophylactic use in surgery?

Answer 1

ANTIBIOTIC PROPHYLAXIS

Antibiotics are medicines that help to stop infection by bacteria.The word ' Antibiotic' by meaning 'Against life' and ''Prophylaxis' means' Prevention of infection' . Antibiotic used for prophylaxis should be active against a wide range of organisms.Antibiotics are applied topical,systemic and entral route.They should be low toxicity and low incidence of allergy,should be involved in the selection of wide range of virulent organisms.

In selecting a prophylactic antibiotic the benefits and detriments associated with each drug should be compared.Also Antibiotic prophylactic gauidlines should be followed.Their are many factors that depends on the selection of prophlactic antibiotics before surgery,

• Special patient population-example paediatric population
• Age and previous surgical history of the patient
• cost effectiveness and side effects of the dug
• The development of future resistance is concerned
• Depending upon the type of the surgery and part of the body or organ involved
• Depending upon the risk factors associated with the disease
• Individual risk factors of every patient(immune suppression,presence of prosthesis,allergies,obesity,malnutrition,diabetes,infection to another site,available pathology or malignancy)

Depending upon the type of surgery antibiotic prophylaxis will change for example,

Surgery of Gastro intestinal system-There is low microbial count in the stomach and duodenum. But if associated with decreased gastric acidity,previous uses of antacids,upper GI bleeding,obesity and malignancy antibiotic prophylaxis usually needed

Colo rectal surgery-Increases risk of infection because of the large number of pathogens present .So antibiotic prophylaxis is mandatory

Biliary tract procedures-Optional , it is needed if risk factors like advanced age,common duct disease,jaundice,previous biliary  tract surgery