Anaesthesia and intensive Care, North university hospital, 13015 Marseille, France.
Anaesthesia and intensive care, hôpital Nord, 42055 Saint-Étienne, France.
Anaesth Crit Care Pain Med. 2019 Oct;38(5):549-562. doi: 10.1016/j.accpm.2019.02.017. Epub 2019 Mar 2.
Infection is a risk for any intervention. In surgery, for example, pathogenic bacteria are found in more than 90% of operative wounds during closure. This exists whatever the surgical technique and whatever the environment (the laminar flow does not entirely eliminate this risk). These bacteria are few in number but can proliferate. They find in the operative wound a favourable environment (haematoma, ischaemia, modification of oxido-reduction potential...) and the intervention induces anomalies of the immune defences. In the case of the installation of foreign material, the risk is increased. The objective of antibiotic prophylaxis (ABP) is to prevent bacterial growth in order to reduce the risk of infection at the site of the intervention. The preoperative consultation represents a privileged moment to decide on the prescription of a ABP. It is possible to define the type of intervention planned, the associated risk of infection (and therefore the necessity or not of ABP), the time of prescription before surgery and any allergic antecedents which may modify the choice of the selected antibiotic molecule.
感染是任何干预措施的风险。例如，在手术中，在关闭时，超过 90%的手术伤口中都存在病原菌。无论手术技术和环境如何（层流并不能完全消除这种风险），这种情况都存在。这些细菌数量很少，但可以繁殖。它们在手术伤口中找到了一个有利的环境（血肿、缺血、氧化还原电位改变等），而干预会引起免疫防御的异常。在安装异物的情况下，风险会增加。抗生素预防（ABP）的目的是防止细菌生长，以降低干预部位感染的风险。术前咨询是决定是否开具 ABP 的最佳时机。可以确定计划的手术类型、相关感染风险（因此是否需要 ABP）、术前开具处方的时间以及任何可能改变所选抗生素分子选择的过敏史。
