The goal of giving antibiotics prior to incision is to allow enough time for the antibiotic to diffuse into the tissues and to develop optimal concentrations of antibiotics in the body.

The CDC has identified 20-50% of all antibiotics given in the United States are either unnecessary or inappropriate.

Risks:

The timing and administration of appropriate antibiotics is very important to successful prevention of SSIs.

Surgeon Tools/Recommendations:

Recommendations for optimal timing of antibiotic prophylaxis:

• Within 1 hour prior to surgical procedure, with most surgeons opting for within 30 minutes of incision.
• Vancomycin and fluoroquinolones may be infused up to 2 hours before surgery due to extended infusion times and long half-lives
• Intraoperative redosing of cefazolin is recommended every 4 hours. Alternatives for patients with a true Penicillin allergy (anaphylaxis breathing issues) include clindamycin and vancomycin.
• Important to review antibiograms or consult with infectious disease team members when deciding on a preferred perioperative antibiotic strategy targeted for patient within a specific area or regions.

Alternatives for patients with a true Penicillin allergy (anaphylaxis, breathing issues) include clindamycin and vancomycin.