Study: Antibiotic prophylaxis not linked to postop antibiotic-resistant infections

Editor's Note

Surgical patients who received antibiotic prophylaxis before low-risk procedures did not have an increased risk for postoperative antibiotic-resistant infections, this study finds.

Of 22,138 patients included in the analysis, 689 developed an infection within 30 days after surgery. Of these, 550 (80%) had received antibiotic prophylaxis, and 338 (49%) had an infection resistant to antibiotics.

A total of 47% of patients with a resistant infection had no antibiotic prophylaxis, compared with 49% who did receive prophylaxis.

The risk was the same whether:

•  antibiotics were given 1 hour or 4 hours before procedures
•  the follow-up period was shortened from 30 to 14 days
•  patients had prior exposure to antibiotics or a prior culture-proven infection.

The only factor associated with a higher risk for postoperative antibiotic-resistant infection was a previous antibiotic-resistant infection. 

Antibiotic-resistant infections have high rates of morbidity and mortality, and exposure to antibiotics is the crucial risk factor for development of antibiotic resistance. If surgical antibiotic prophylaxis (SAP) increases risk for antibiotic-resistant infections, prophylaxis may cause net harm, even if it decreases overall infection rates.

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