Friday, November 27, 2015

Antibiotic Resistance on Surgery and Cancer chemotherapy Antibiotic Prophylaxis in the USA

What is the impact of declining antibiotic susceptibility on antibiotic prophylaxis in surgery and cancer chemotherapy? Here is  paper recently published on that subject in Lancet Infectious Diseases by my colleague Dan Morgan from the University of Maryland.

The authors estimated that between 39% and 51% of pathogens causing surgical site infections (SSIs) and 27% of pathogens causing infections after chemotherapy are resistant to standard prophylactic antibiotics in the USA.

This is a problem and we definitely need more data to systematically assess the efficacy of antibiotic prophylaxis. Further, we need timely guidance on how best to modify prophylaxis based on the evolving landscape of antimicrobial resistance.

As part of SSI tracking, health system epidemiology teams should critically assess the antibiograms of all SSI isolates to better understand the local prophylactic drug-bug mismatch. This should include assessment of mupirocin and chlorhexidine resistance when staphylococcal decolonization is attempted pre-operatively.

This is precisely our strategy at VCU Health.