Medical College of Wisconsin, Milwaukee, WI.
University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
Am J Infect Control. 2017 Nov 1;45(11):1259-1266. doi: 10.1016/j.ajic.2017.04.012. Epub 2017 Jun 5.
The global push to combat the problem of antimicrobial resistance has led to the development of antimicrobial stewardship programs (ASPs), which were recently mandated by The Joint Commission and the Centers for Medicare and Medicaid Services. However, the use of topical antibiotics in the open surgical wound is often not monitored by these programs nor is it subject to any evidence-based standardization of care. Survey results indicate that the practice of using topical antibiotics intraoperatively, in both irrigation fluids and powders, is widespread. Given the risks inherent in their use and the lack of evidence supporting it, the practice should be monitored as a core part of ASPs, and alternative agents, such as antiseptics, should be considered.
全球对抗抗菌药物耐药性问题的推动，促使了抗菌药物管理项目（ASPs）的发展，最近这一项目已经被联合委员会和医疗保险和医疗补助服务中心所要求。然而，这些项目通常不会监测开放性手术伤口中局部抗生素的使用情况，也没有任何基于证据的标准化护理标准。调查结果表明，在手术中使用局部抗生素，无论是冲洗液还是粉末，都是普遍存在的。考虑到其使用存在固有风险，且缺乏支持其使用的证据，因此应将该实践作为 ASPs 的核心部分进行监测，并且应考虑使用替代药物，如防腐剂。
