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Prophylactic antibiotics are used to reduce the number of infections after surgical intervention. However, prophylactic antibiotics should be used according to the doctor's prescription.
1.What are prophylactic antibiotics? Antibiotic prophylaxis is the use of a short course of antibiotics just before surgery and ends within 24 hours. The purpose of antibiotics is to minimize the risk of an infection occurring before an infection occurs. Prophylactic antibiotics must be used in situations where there is a high risk of infection, so antibiotics should be administered prior to surgery, achieving bactericidal concentrations in tissues at the time of most infection. In addition, prolongation of prophylactic antibiotics after surgery is usually not meaningful. Prophylactic antibiotics can reduce the frequency of infections that occur after some surgeries that do not completely eliminate surgical site infections. It is therefore not possible to rely solely on prophylactic antibiotics and to neglect infection control measures.
2. Indications for antibiotic prophylaxis Surgery is divided into 4 types: clean surgery, clean surgery - infected, infected surgery, dirty surgery. Of the four types mentioned above, prophylactic antibiotics are used when there is no infection, so it is only applicable to clean or clean-contaminated surgery. Cases of suspected or confirmed infection, i.e. infected or dirty surgery, require antibiotic treatment.
Sử dụng kháng sinh dự phòng trong phẫu thuật
3. How to choose prophylactic antibiotics? The selected prophylactic antibiotic should ensure the following:
Prophylactic antibiotic used for that type of surgery has evidence from clinical trials, reducing surgical site infections. Use an antibiotic that should be safe, prevent infection, be inexpensive, and be a broad-spectrum antibiotic that is bactericidal against most bacteria that may be infected during surgery.
4. When to give prophylactic antibiotics? Time the first dose of antibiotic so that the highest bactericidal concentration is achieved in serum and tissue before skin incision. And antibiotic serum and tissue concentrations during surgery, and several hours after suturing, thus:
A single intravenous dose of antibiotics at induction of anesthesia or up to 30-45 minutes preoperatively normally allows tissue concentrations required during surgery. The use of prophylactic antibiotics during surgery is indicated in cases of prolonged surgery (>3 hours) or 1st injection 2 hours before skin incision because the drug concentration in the tissue drops too low at the time of skin closure. so a repeat dose is required. 5. Precautions when using prophylactic antibiotics Weigh the benefits and risks. Note the toxicity of antibiotics; Using intravenous line, intramuscular injection is recommended to prevent anaphylaxis according to the correct regimen; Prevent antibiotic resistance. Use the correct dose as prescribed by your doctor; Prophylactic antibiotics should be appropriate for the type of bacteria suspected of infection.
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