Less antibiotics after surgery



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Preventive antibiotic use during surgery should be reduced

Antibiotics are often administered as part of surgical procedures to minimize the risk of infections - especially wound infections. However, the excessive use of antibiotics favors the emergence of resistant hospital germs. The German Society for Surgery (DGCH) and the German Society for General and Visceral Surgery (DGAV) are therefore calling for the preventive use of antibiotics to be significantly reduced.

At the 131st surgeons' congress in Berlin at the end of March, the experts from the DGCH and DGAV want to present a five-point plan that "can reduce the number of wound infections but at the same time prevent unnecessary use of antibiotics." Although "patients who suffer from surgical There are twice as many infections as there are patients in other disciplines, ”but the preventive administration of antibiotics is only of limited use, according to the surgeons' associations. "The one-time administration of an antibiotic before an intervention under three hours is completely sufficient, but further prophylaxis after the operation is superfluous," reports the DGCH in its current press release. The DGCH President Professor Dr. med. According to Joachim Jähne, "the motto here is: less is more."

Five-point plan for antibiotic use As an example of operations in which wound infections occur particularly frequently, the surgeons' associations cite interventions in the abdominal cavity. Around 20 percent of patients suffer from an infection after an appropriate operation, according to the DGCH report. The prophylactic administration of antibiotics can only influence this risk to a limited extent. In order to ensure optimal prevention and still avoid the emergence of resistant hospital germs, the DGAV has developed a five-point plan for handling antibiotics before and after surgery. The DGCH reports that "the selection of a suitable antibiotic in the correct dosage" comes first.

Professor Stefan Maier, chief physician of general and abdominal surgery at the Kaufbeuren Clinic, explained that "an interdisciplinary group has drawn up a list of recommendations". For example, the recommendation takes into account "which pathogens have already developed resistance to antibiotics," reports the DGCH. The list also made it clear "which procedures - such as thyroid surgery - can be done without antibiotics," emphasized Dr. Christian Eckmann, chief physician at the Clinic for General, Visceral and Thoracic Surgery at the Peine Clinic. Together with Professor Maier, he heads the DGAV's Visceral Surgical Infections working group. Furthermore, it is stipulated that the administration of the antibiotic is the task of anesthesia and it must be ensured that the prophylaxis takes place reliably sixty to thirty minutes before the procedure in order to achieve an optimal effect.

One-time administration of antibiotics is often sufficient According to the experts, one-time administration of antibiotics is sufficient for surgery that is expected to last no longer than three hours. "The antibiotic should only be re-administered during the procedure if the operation is lengthy or there is a heavy loss of blood," explained Professor Maier. According to the surgeons' associations, the administration of appropriate medication beyond the operation must be avoided. "This last point is particularly important to us" because "it is (of no use) to continue to use antibiotics as a preventive measure after the operation," emphasized Christian Eckmann. The unnecessary use of antibiotics promotes the development and spread of life-threatening hospital infections, because so-called multi-resistant hospital germs develop that no longer respond to common antibacterial agents. (fp)

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Video: Management of Acute Peri-Prosthetic Injection with Two Stage Debridement and Antibiotic Beads


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