Holmberg D L
Vet Clin North Am. 1978 May;8(2):219-27. doi: 10.1016/s0091-0279(78)50030-0.
"Sound and careful surgery is the sine qua non of wound management; antimicrobials are adjunctive." The key to successful use of prophylactic antibiotics in surgery is careful selection of cases and medication. There are no final rule or formulas that will always give optimal results. Listed below are some guidelines that may assis the clinician in determining the need and form of antimicrobial use. 1. The operation must carry a significant risk of bacterial contamination. Refined-clean and clean procedures should not be given prophylactic antibiotics. 2. Bacterial cultures should be taken when possible, and the medication used for prophylaxis should be effective against the organisms expected to be encountered. 3. Narrow spectrum antibiotics should be used to conserve the body's normal flora. Broad spectrum antibiotics needed to combat resistant infections should not be used for prophylaxis. 4. The antibiotic should be present in the wound in effective concentrations at the time of the incision and be maintained only as long as the risk of new bacterial contamination exists.
“合理且精细的手术是伤口处理的必要条件；抗菌药物起辅助作用。”手术中成功使用预防性抗生素的关键在于仔细选择病例和用药。不存在总能产生最佳效果的最终规则或公式。以下是一些可能有助于临床医生确定抗菌药物使用需求和形式的指导原则。1. 手术必须有显著的细菌污染风险。精细清洁手术和清洁手术不应使用预防性抗生素。2. 尽可能进行细菌培养，用于预防的药物应能有效对抗预期会遇到的微生物。3. 应使用窄谱抗生素以保护机体的正常菌群。对抗耐药感染所需的广谱抗生素不应用于预防。4. 抗生素应在切开时在伤口中达到有效浓度，并仅在存在新细菌污染风险时持续使用。
