Operations that do not involve the violation of the GI/biliary or respiratory tracts or do not introduce synthetic prosthetic devices (e.g., cardiac valve or joint replacement) do not require prophylactic antibiotics. Otherwise, a single dose of the appropriate antibiotic administered within 30 minutes prior to incision is generally recommended as prophylaxis against infection the usual skin, respiratory tract, or GI tract flora Full text of American Society of Hospital Pharmacists 2013 Antibiotic Prophylaxis Guide is available at:
https://www.ashp.org/DocLibrary/BestPractices/TGSurgery.aspx
For operations classified as clean and without placement of foreign material no antibiotic prophylaxis is indicated.
Mobile application (app) developed for antibiotics guidelines: The URLs are as follows:
For android phones:
https://play.google.com/store/apps/details?id=com.absn.absn
For windows based phones:
http://www.windowsphone.com/en-in/store/app/antibiotic/e7d3040e-c373-409b-9007-2844f0f68c11
For iphones:
https://itunes.apple.com/us/app/antibiotics-absn/id841289993?mt=8
In our Institution no antibiotic prophilaxis is given for clean surgery.
We do not use antibiotics in a clean procedure which does not involve use of prosthesis. Otherwise a single dose of Augmantin 1.2gm at induction is give.
Its appreciable that this thread's consensus so far is no antibiotics in a clean surgery.
Earlier antibiotic prophylaxis was used for any surgery in a pt with 'cardiac disease'. The present day guideline has moved away from this and going onto specifics such as
- wound type
- type of cardiac disease (valvular, cyanotic)
- duration of procedure
Is this agreeable ?
If there are no extenuating circumstances, cardiac issues, immunocompromise, incarceration, planned mesh/prosthetic appliance, etc we do not use prophylactic antibiotics for elective hernia repair.
Antibiotic prophylaxis may be needed even in clean and day surgeries in day case surgeries if the patient's personal and environmental hygiene is inadequate
They're all clean operations, so no antibiotics used. I note Dr Bhutiani's answer above - we would not routinely use antibiotics when inserting surgical central lines.
As a policy we do not use perioperative antibiotics for uncomplicated hernia repair, circumcision or orchidopexy. Underlying cardiac issues, VP shunts in hernia sac, recent balanitis may require coverage.
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