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Re: WINDOW TIME FRAME FOR PRE-OP ANTIBIOTICSFrom: Braun, R. Daniel (rbraun@iupui.edu)Thu Jun 20 16:25:23 2002
That is for Major Gynecologic procedures not for Cesarean sections. -----Original Message----- From: ainsron@sbcglobal.net [mailto:ainsron@sbcglobal.net] Sent: Thursday, June 20, 2002 3:42 PM To: Multiple recipients of list OB-GYN-L Subject: Re: WINDOW TIME FRAME FOR PRE-OP ANTIBIOTICS Here's the recommendations from ACOG: CLINICAL MANAGEMENT GUIDELINES FOR OBSTETRICIAN-GYNECOLOGISTS NUMBER 23, JANUARY 2001 (Replaces Technical Bulletin Number 237, June 1997) " State-of-the-art aseptic technique has been associated with a dramatic decrease in operative-site infections, but bacterial contamination of the operative site is inevitable. The in vivo interaction between the inoculated bacteria and prophylactically administered antibiotic is one of the most important determinants of the state of the surgical site. Systemic antibiotic prophylaxis is based on the belief that antibiotics in the host tissues can augment natural immune-defense mechanisms and help to kill bacteria that are inoculated into the wound. Only a narrow window of antimicrobial efficacy is available, requiring the administration of antibiotics either shortly before or at the time of bacterial inoculation (eg, when the incision is made, viscus entered, or pedicles clamped). A delay of only 3-4 hours can result in ineffective prophylaxis (4). The induction of anesthesia represents a convenient time for initiating antibiotic prophylaxis in major gynecologic procedures. Current data indicate that for lengthy procedures, additional, intraoperative doses of an antibiotic, given at intervals of one or two times the half-life of the drug, maintain adequate levels throughout the operation (5). A second dose of the prophylactic antibiotic also may be appropriate in surgical cases with an increased blood loss (>1,500 mL). Neither subsequent doses nor treatment for several days before a procedure is indicated for prophylaxis. The use of prophylaxis implies that the patient is presumed to be free of infection at the time of the procedure. During a procedure when a patient is found to be at greater risk for disease, use of therapeutic antibiotics should be considered."
>Can you tell me the time frame established by the APIC group that
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