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HICprevent

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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Unpreventable? Antibiotics Routinely used in Surgery Waning

January 13th, 2016

By Gary Evans, Senior Staff Writer

The warning flag signaling a post-antibiotic era of untreatable infections has been hoisted time and again to add urgency and much needed action on drug stewardship. But in addition to becoming untreatable, infections are at risk of becoming unpreventable.

Antibiotics used routinely for surgical prophylaxis to prevent surgical site infections are losing efficacy against drug-resistant bacteria. This insidious nuance to the international problem of antibiotic resistance is raised in a new modeling study.1 The research indicates the loss of prophylactic antibiotics routinely given to surgical and immune compromised patients to prevent infections could be as disastrous as losing drug efficacy for treatment.

In a “fairly realistic” scenario, a 30% loss of prophylactic drug effectiveness from current levels would translate to 120,000 additional infections and 6,000 more patient deaths annually, says study co-author Ramanan Laxminarayan, PhD, MPH, director of the Center for Disease Dynamics, Economics & Policy in Washington, D.C.

“That is quite a large number when you consider that these infections are a ‘side effect’ of undergoing surgery,” he says. “But what is more subtle and difficult to quantify is the fact that the high risk of infection and mortality could influence decision making on the part of patients as to whether they want to go through with a hip or knee replacement. I think the real takeaway here is that modern medicine and a lot of surgery depends on effective antibiotics. If we [lose] antibiotics then we have to give up many of the gains of modern medicine.”

For more on this story see the February 2016 issue of Hospital Infection Control & Prevention.

Reference

1. Teillant A, Gandra S, Barter D, et al. Potential burden of antibiotic resistance on surgery and cancer chemotherapy antibiotic prophylaxis in the USA: A literature review and modelling study. Lancet Infect Dis 2015;15:1429–1437.