Antimicrobial Prophylaxis in Surgery: General Concepts and Clinical Guidelines

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Abstract
Bacteria are found in 90% of surgical incisions, regardless of surgical technique or environment. Initially, the number of pathogens is low, but proliferation is facilitated by favorable local conditions and weakened host defense mechanisms. The principles of presurgical administration of antibiotics are well defined, but a few controversies persist. An ideal antimicrobial agent would not induce bacterial resistance in pathogenic organisms, would penetrate tissues effectively, would have a long enough half-life so that a single injection could guarantee protection throughout the operation, would have a low toxicity, would not interfere with anesthetics, would be easy to administer, and would be cost-effective.