Antibiotic Prophylaxis: Definition & Guidelines

Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

Probably all of us have taken antibiotics for an infection. However, in some cases antibiotics are given when you don't have an infection. This lesson provides further details and example scenarios about antibiotic prophylaxis.

Increased Risk of Infection

Your body is an amazing work of art that consists of a multitude of systems working together. In a perfect world, all of these systems work together seamlessly for a perfectly functioning human being. But, if contaminants enter your perfect body, it can cause illnesses. Sickness doesn't just randomly happen. A bacteria or virus has to gain access to your body where it multiplies and causes you to be sick.

If someone is ill with a cold and they sneeze near you, you will likely breathe in those germs and will get sick as a result. Or what if you cut your finger with a knife? Suddenly, you have a new opening for germs to enter and attack your body. Likely, there were germs on the knife or on your hand you used to grab your bleeding finger. The germs love you because you just helped them infect you!

Advances in healthcare are quite astounding; interventions can fix and repair many problems. It's important to keep in mind there are always risks involved with procedures. Any time your body is opened, it comprises your body and puts you at a high risk for infection.

Dental Procedures

LaVon is elderly with heart disease. She has a dental procedure planned to remove a couple of teeth. Her dentist explains that she needs antibiotic prophylaxis prior to the procedure. Antibiotics are medications that are given for infections. Typically, you take the antibiotics when you have a current infection. Antibiotic prophylaxis is a practice for use of antibiotics when there is no active infection present, but there is a high risk of developing an infection.

Remember, LaVon has damaged heart valves. As discussed above, anytime you open up the body, there is a risk of bacteria entering the body. When she has the dental procedure done, the bacteria that may enter her body is able to travel to her heart and cause endocarditis, inflammation of the inner lining of the heart chambers and valves.

The dentist explains that some people with joint replacements, such as knee or hip, sometimes need prophylactic antibiotics before dental procedures as well. Several years ago, many more people were receiving antibiotics prior to dental procedures. Research has changed the frequency of this practice. Not everyone with an artificial joint or heart disease needs antibiotic prophylaxis. There are risks with taking antibiotics, such as side effects and the development of antibiotic resistant bacteria. The risks and benefits need to be weighed prior to prescribing antibiotics.

Antibiotics commonly used for dental procedures are amoxicillin or ampicillin.

Surgery

Any type of surgery greatly increases your risk of infection. Despite all the careful techniques that involve a sterile field during surgery, your body is surgically opened and bacteria from your skin or the environment can possibly enter your body and cause an infection. This is called a surgical site infection.

Research has been done to determine appropriate guidelines for antibiotic prophylaxis for different types of surgery. The goal is that antibiotic prophylaxis will prevent a surgical site infection, as well as prevent illness or death from the surgical site infection. By preventing the infection, it would reduce the costs and the length of hospitalization. The antibiotic would not produce any adverse effects or have any complications for the patient or the hospital.

Guidelines include:

  • Choosing an antibiotic that is effective against the bacteria most likely to cause an infection
  • Giving at the most appropriate time
  • Prescribing the most appropriate dosage

Angie is having nausea, vomiting, and pain in her right lower part of her abdomen. She goes to the emergency room where she is diagnosed with appendicitis and is scheduled for surgery. As they are preparing her for surgery, the doctor explains that she will receive antibiotic prophylaxis to help prevent any infection from the surgery.

She has an IV in place and the doctors administer a cephalosporin antibiotic as well as metronidazole (another type of antibiotic that fights bacteria) shortly before they take her into surgery.

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