van den Bogaard A E
Tijdschr Diergeneeskd. 1984 Aug 15;109(15-16):616-27.
Experimental studies in animals carried out by Burke in 1961 showed that antibiotics will only have a beneficial effect on primary wound infection when they are administered shortly before or after bacterial contamination. To ensure an optimal effect there should be an adequate concentration of a suitable antibiotic in the tissues at the time of contamination, i.e. during surgery. During operation, resistance to infection is considerably reduced, so that infection may be caused by an inoculum present in a rather low concentration which would be too small to have this effect in normal conditions. This reduced resistance to infection only continues until a few hours after operation. Prophylactic use of antibiotics therefore has to be continued until shortly after the final stage of the operation. A large number of clinical trials in human medicine definitely showed that short-term perioperative short-term perioperative prophylactic use of antibiotics causes a marked reduction in the incidence of postoperative septic complications. As long as clinical trials have not been done in small animal clinics, it would appear to be sensible to apply the abundant results obtained in experimental studies in animals and clinical trials in human medicine to small animal surgery. Prophylactic use of antibiotics is indicated when the risk of infection or the severity of possible complications outweigh the disadvantages of the regular use of antibiotics. The risk factors in the development of wound infection and the choice of antibiotics are discussed.
伯克在1961年对动物进行的实验研究表明，抗生素只有在细菌污染之前或之后不久给药，才会对原发性伤口感染产生有益效果。为确保最佳效果，在污染时，即手术期间，组织中应含有足够浓度的合适抗生素。手术过程中，抗感染能力会大幅降低，因此，感染可能由浓度相当低的接种物引起，而在正常情况下，这种浓度过低的接种物不会产生感染。这种抗感染能力的降低仅持续到术后数小时。因此，预防性使用抗生素必须持续到手术最后阶段后不久。大量针对人类医学的临床试验明确表明，围手术期短期预防性使用抗生素可显著降低术后败血症并发症的发生率。只要尚未在小动物诊所进行临床试验，将在动物实验研究和人类医学临床试验中获得的大量结果应用于小动物手术似乎是明智的。当感染风险或可能并发症的严重程度超过常规使用抗生素的弊端时，就应使用预防性抗生素。本文讨论了伤口感染发生的风险因素及抗生素的选择。
