Clinical practice guidelines for surgical antimicrobial prophylaxis: Qualitative appraisals and synthesis of recommendations

Abstract

Several CPGs for SAP were developed without the desired methodological rigour or transparency. Synthesis of recommendations for best-evaluated CPGs provides a broad approach owing to the complementarity of the recommendations.

Clinical Issues—February 2019

“…An evidence‐based approach for preoperative antibiotic timing at your organization should be based on current surgical antimicrobial prophylaxis guidelines . The organization should form an interdisciplinary team of key stakeholders to design a standardized process for integrating the current guidelines into established workflows (Table ).…”

“…The organization should form an interdisciplinary team of key stakeholders to design a standardized process for integrating the current guidelines into established workflows (Table ). According to researchers and clinical practice guidelines, the best timing for prophylactic antibiotic administration is unclear . However, most researchers agree that the antibiotic administration should be complete at the time of incision, and that a range of up to 120 minutes for some antibiotics with longer infusion times before incision is acceptable .…”

“…According to researchers and clinical practice guidelines, the best timing for prophylactic antibiotic administration is unclear . However, most researchers agree that the antibiotic administration should be complete at the time of incision, and that a range of up to 120 minutes for some antibiotics with longer infusion times before incision is acceptable . The Centers for Disease Control and Prevention recommends administration of preoperative antimicrobial agents only when indicated, and that they be timed such that a bactericidal concentration of the agents is established in the serum and tissues when the incision is made.…”

“…In 2017, Wainberg et al conducted qualitative appraisals and a synthesis of international clinical practice guidelines for preoperative prophylactic antibiotic administration. The researchers appraised 29 clinical practice guidelines for quality using the AGREE (Appraisal of Guidelines for Research & Evaluation) II tool and checked them for conflicting recommendations.…”

“…The researchers appraised 29 clinical practice guidelines for quality using the AGREE (Appraisal of Guidelines for Research & Evaluation) II tool and checked them for conflicting recommendations. They found that the only difference among clinical practice guidelines was related to the initiation time of the preoperative prophylactic antibiotic . A summary describing these differences is found in Table .…”