ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery

The ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery, which have provided practitioners with standardized effective regimens for the rational use of prophylactic antimicrobials, have been revised as described in this document on the basis of new clinical evidence and additional concerns. Recommendations are provided for adult and pediatric patients (1 to 21 years of age), including infants (one month to 2 years of age). Geriatric patients, newborns (premature and full-term), and patients with renal or hepatic dysfunction are not specifically addressed. Therefore, the guidelines may not be applicable to these patients, or certain adjustments to the recommendations may be necessary. The higher occurrence of resistant organisms and the importance of controlling health care costs are also considered. Prophylaxis refers to the prevention of an infection and can be characterized as primary prophylaxis, secondary prophylaxis (suppression), or eradication. Primary prophylaxis refers to the prevention of an initial infection. Secondary prophylaxis refers to the prevention of recurrence or reactivation of a preexisting infection (e.g., prevention of the recurrence of a latent herpes simplex virus infection). Eradication refers to the elimination of a colonized organism to prevent the development of an infection (e.g., eliminating methicillin-resistant Staphylococcus aureus [MRSA] from the nares of health care workers). These guidelines focus on primary prophylaxis. Secondary prophylaxis and eradication are not addressed.