Less antibiotics after surgery

Preventive antibiotic use during surgery should be reduced

04/03/2014

In the context of surgery, antibiotics are often given to minimize the risk of infections, particularly wound infections. But the overuse of antibiotics favors the emergence of resistant hospital germs. The German Society of Surgery (DGCH) and the German Society of General and Visceral Surgery (DGAV) therefore demand that the use of antibiotics be significantly reduced.

At the 131st Congress of Surgeons at the end of March in Berlin, the experts of DGCH and DGAV want to present a five-point plan, with which „The number of wound infections can be reduced, but at the same time unnecessary antibiotic use can be prevented.“ Although suffer „Patients in surgical settings are twice as likely to have infections as patients in other disciplines“, but the preventive administration of antibiotics makes only limited sense, according to the statement of the surgeons' associations. „The single administration of an antibiotic before an intervention under three hours is quite sufficient, a further prophylaxis after surgery, however, superfluous“, reports the DGCH in its current press release. The DGCH President Professor med. According to Joachim Jähne „Here's the motto: less is more.“

Five-point antibiotic use plan
As an example of operations in which wound infections are particularly frequent, the surgeon's associations call surgery in the abdominal area. Approximately twenty percent of patients suffer infection after surgery, according to the DGCH communication. The prophylactic administration of antibiotics, however, can only partially influence this risk. To ensure optimal prevention while avoiding the emergence of resistant hospital germs wherever possible, the DGAV has developed a five-point plan for the management of antibiotics before and after surgery. First, stand the „the selection of a suitable antibiotic in the correct dosage“ in the first place, reports the DGCH.

Professor Stefan Maier, chief physician of general and visceral surgery at the Klinikum Kaufbeuren, explained that „an interdisciplinary group with a list of recommendations“ created. The recommendations are taken into account, for example, „which pathogens have already developed resistance to antibiotics“, reports the DGCH. The list is also clear, „which interventions - such as thyroid surgery - can be done without antibiotics“, emphasized Privatdozent med. Christian Eckmann, Chief Physician of the Clinic for General, Visceral and Thoracic Surgery at Klinikum Peine. Together with Professor Maier, he leads the working group on Visceral Surgical Infections of the DGAV. Furthermore, it is stated that the administration of the antibiotic is an anesthetic task and must be ensured that the prophylaxis is reliable sixty to thirty minutes before the procedure in order to achieve an optimal effect.

One-time administration of antibiotics is often enough
Surgery, which is expected to take no longer than three hours, is sufficient, according to the experts, a single dose of antibiotics. „Only if prolonged surgery or severe blood loss, the antibiotic should be given again during the procedure“, explained Professor Maier. The administration of appropriate medication beyond surgery is the surgeons' associations, according to the essential to refrain. „This last point is particularly important to us“, there „it is useless to continue to use antibiotics after surgery“, 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)