Perioperative antibiotic prophylaxis of infections in abdominal surgery: evidence–based medicine and current trends

Objective. To summarize the results of our own research on the use of perioperative antibiotic prophylaxis in abdominal surgery and modern approaches to antibiotic prophylaxis from the perspective of evidence–based medicine. Materials and methods. The results of treatment of 415 patients with acute abdominal pathology, of whom 165 developed peritonitis, and current international recommendations for the use of perioperative antibiotic prophylaxis in abdominal surgery were analyzed. Results. For effective perioperative antibiotic prophylaxis as a key element of infection prevention strategy, it is important to adhere to the basic principles defined by international standards and confirmed by clinical experience. Conclusions. Perioperative antibiotic prophylaxis for abdominal infections reduces the risk of complications and prevents the development of antibiotic resistance. Antimicrobial monotherapy, such as imipenem–cilastatin, is effective in elective colorectal surgery; in non–elective surgery, a combination of parenteral antibiotics effective against typical intestinal pathogens is recommended. The implementation of control checklists and local protocols for perioperative antibiotic prophylaxis based on microbiological monitoring is recommended. Perioperative antibiotic prophylaxis is a supplement to surgical standards, not a replacement for them.