Guidelines for Preventing Surgical Infection

New guidelines developed by a large panel of U.S. doctors are designed to help prevent surgical infections, the second-most common cause of hospital-acquired infections. The guidelines were published in the June 15, 2004, issue of Clinical Infectious Disease.

The most important recommendation by the panel was that antibiotics should be given one hour before surgery and should not be used for more than 24 hours after the end of the operation. Currently, only about 55% of surgical patients receive antibiotics within an hour of surgery. Nationally, antibiotics are currently continued for an average of 40 hours following a surgical procedure.

The four main causes of surgical site infection are inconsistent use of antibiotics, using the wrong antibiotics, inconsistent timing of antibiotic administration, or complete failure to use antibiotics prior to surgery. Patients who develop surgical site infections are up to 60% more likely to spend time in the intensive care unit, where care is more costly for the patient and the hospital. They are also five times more likely to be re-admitted to the hospital. Each infection is estimated to increase a hospital stay by an average of seven days and add more than U.S.$3,000 in costs.

"For some surgical procedures, hospitals are administering antibiotics as long as 96 hours following surgery, so a real savings opportunity exists for hospitals that adhere to the guidelines,” said John Hitt, M.D., vice president of clinical improvement for VHA, Inc. (Irving, TX, USA), an alliance of not-for-profit healthcare organizations working to improve community healthcare.