Читать книгу Surgery of Exotic Animals - Группа авторов - Страница 20

The aim in administering perioperative antibiotics is that the blood level of antibiotic will be effective in preventing incision site infection from target organisms. In most cases, the target organisms are normal skin flora that cannot be completely eliminated during patient skin preparation. The antibiotic should be administered prior to making an incision, which is when the first exposure occurs and should continue until the surgery is complete so any blood clots that form will have therapeutic levels of antibiotic. If the patient is already receiving antibiotics for treatment of an infection and has therapeutic circulating levels of antibiotics effective against the target organisms, additional IV perioperative antibiotic is not needed. If the therapeutic antibiotic is not expected to be effective against the surgical target organisms, perioperative antibiotic administration of an antibiotic expected to be effective against the surgical target organisms should be administered perioperatively. For example, if a patient is receiving cephalexin for a skin infection, but the surgery is in the perineal area where fecal contamination is a concern, adding a perioperative antibiotic against which fecal flora are likely to be sensitive is appropriate. There is no evidence that continuing to administer a perioperative antibiotic for a brief period of time postoperatively is beneficial for preventing surgical site infections (SSIs) and may select for resistant organisms.