Show Notes
Episode Notes
The Society of Infectious Diseases Pharmacists is excited to invite you to the first ever meeting (via Breakpoints) of The Tortured Stewards & Surgeons Department. Today’s agenda items: optimal management of perioperative antibiotics and prevention of surgical site infections.
Drs. Trisha Peel (@DrTrishaPeel), Michael Calderwood (@CalderwoodMD) and Patch Dellinger join Dr. Jillian Hayes (@thejillianhayes) to discuss some of the controversies we encounter while managing antibiotics in the perioperative space. Does anyone really need post-op antimicrobial prophylaxis longer than 24 hours? Where should vancomycin be fitting into surgical prophylaxis regimens? Can we truly give pre-operative cefazolin to patients with a penicillin allergy? Tune in for the answers to these questions and more!
Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About X: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp
If you’d like more information about the CALIPSO trial, please visit this link: https://www.anzca.edu.au/profiles/ctn-trials/underway/calipso
Bibliography
SSI Infection Prevention Review: https://jamanetwork.com/journals/jama/article-abstract/2800424#:~:text=Six%20are%20supported%20by%20randomized,use%20a%20chlorhexidine%20gluconate%2Dalcoho
Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update: https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/strategies-to-prevent-surgical-site-infections-in-acutecare-hospitals-2022-update/2F824B9ADD6066B29F89C8A2A127A9D
American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update: https://journals.lww.com/journalacs/citation/2017/01000/american_college_of_surgeons_and_surgical.8.aspx
2017 CDC Guidelines: https://jamanetwork.com/journals/jamasurgery/fullarticle/2623725
2018 WHO Guidelines: https://arthroplasty.biomedcentral.com/articles/10.1186/s42836-022-00113-y
ASHP Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery: https://www.ashp.org/surgical-guidelines
Surgeons as Stewards: https://journals.lww.com/journalacs/citation/2020/12000/perioperative_antibiotic_prophylaxis__surgeons_as.23.aspx
Li et al, Arthroplasty 2022: https://arthroplasty.biomedcentral.com/articles/10.1186/s42836-022-00113-y
Dutch Arthroplasty Register Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023957/
de Jonge Meta-Analysis on duration and incidence of SSI: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30084-0/abstract
Prolonged Antibiotic Prophylaxis After Cardiovascular Surgery and Its Effect on Surgical Site Infections and Antimicrobial Resistance: https://www.ahajournals.org/doi/10.1161/01.cir.101.25.2916?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
RCT - Nasal Iodophor Antiseptic vs Nasal Mupirocin Antibiotic in the Setting of Chlorhexidine Bathing to Prevent Infections in Adult ICUs: https://jamanetwork.com/journals/jama/article-abstract/2810510
NYU Langone Study - Preventing Surgical Site Infections: A Randomized, Open-Label Trial of Nasal Mupirocin Ointment and Nasal Povidone-Iodine Solution: https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=91dee3e1445adb80d533f2c210816a3285254e3a
Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty: https://www.nejm.org/doi/full/10.1056/NEJMoa2301401
What Is the Primary Driver of Preoperative Vancomycin Use? It’s Not Methicillin-resistant Staphylococcus aureus—or Allergy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744972/
Drug allergy: a 2022 practice parameter update: https://www.jacionline.org/article/S0091-6749(22)01186-1/fulltext
Perioperative use of cefazolin without preliminary skin testing in patients with repor
More from Breakpoints
Does oseltamivir harm critically ill patients with influenza? In this Breakpoints and Communicable collaboration, Erin McCreary and Josh Davis are joined by Steve Webb and Steve Tong to discuss the REMAP-CAP trial results that are challenging a long-standing intensive care practice. Together, they review the study design, key findings, and implications for clinical care, while highlighting the importance of randomized clinical trials in shaping evidence-based medicine. At the time of recording, the REMAP-CAP results were available as a preprint.
Dr. Prathit Kulkarni, lead author of a recent state-of-the-art review on acute and chronic bacterial prostatitis, joins host Dr. Erin McCreary to discuss this complex disease state. They walk through diagnosis, epidemiology, treatment, and more. You won’t want to miss this episode!
Gram-negative resistance is beautifully intricate, scientifically elegant, and very complex. Nothing is more exciting than the recently approved and bursting pipeline of beta-lactamase inhibitors. Listen to Drs. Sam Aitken and Christophe Le Terrier, along with host Dr. Erin McCreary, describe the nuanced enzymology and other antibacterial properties of beta-lactamase inhibitors. This episode also discusses the concepts of stand-alone inhibitors, resistance development, and more. If you want to learn more about sulbactam, clavulanic acid, tazobactam, avibactam, relebactam, vaborbactam, durlobactam, enmetazobactam, zidebactam, nacubactam, ledaborbactam, taniborbactam, and xeruborbactam – this episode is for you!