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Surgery Patients and Antibiotic Resistance

Surgery Patients and Antibiotic Resistance


Are the prophylactic regimens used in mainstream medicine part of the growing resistance problem in the U.S.? Recent reports suggest the use of antibiotics to lower the risk of surgical site infections may actually be at the heart of the increase in superbug outbreaks in this country.

Growing Concern Regarding Resistance

Medical science cannot ignore the increasing rate of bacterial resistance to commonly prescribed antibiotics. Examiners with the Center for Disease Dynamics, Economics & Policy looked at metaanalyses of randomized controlled trials from 1968 to 2011 to determine how efficient antibiotic prophylaxes are in preventing infections. What they found was 39 percent of all surgical site infections after a caesarean and 50 to 90 percent after transrectal prostate biopsy were resistant to standard treatments.

There is an overall 10 percent drop in the efficacy of these prophylaxis treatments. Studies show that a 30 percent reduction could result in as many as 120,000 infections and 6.300 deaths each year. Even with 10 percent drop, researchers predict an additional 40,000 infections in the U.S. with over 2,000 people dying as a result.

This represents some of the strongest evidence to date of an increasing antibiotic resistance and the potential consequences for surgery patients. The risk extends beyond the surgical theater, as well, to patients getting chemotherapy. It is standard to give antibiotics to any patient vulnerable to infection because it can seriously hinder their recovery. It is estimated that a quarter of the infections developed by chemotherapy patients are already resistant to prophylactic antibiotics.

Finding New Ways to Battle Infections

The reality of the situation is that existing antibiotic prophylactics are losing their punch. The medical community must find ways to prevent this situation from escalating further and to support efforts to prevent a worldwide epidemic of antimicrobial resistance. That comes from being diligent regarding cross-contamination controls and medical protocols put in place to prevent surgical site infections.

The increasing risk of antibiotic resistance threatens the safety of patients and the effectiveness of surgical procedures and immunosuppressing chemotherapy. More studies need to be done to determine the rate of decline, but this initial analysis shows as much as a 70 percent reduction in efficacy. An editorial written by Joshua Wolf, MD with St. Jude’s Children’s Research Hospital calls for clinicians take responsibility for preventing further decline  by taking advantage of systemic interventions like improved education, better guidelines regarding infection control and by restricting their use of antibiotics.

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