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National Clinical Programme for Surgery and HSE agree joint position on surgical antibiotic prophylaxis

A new position statement on the recommended maximum duration of antibiotic prophylaxis for surgery has been agreed by the RCSI National Clinical Programme for Surgery (NCPS), the HSE antimicrobial resistance and infection control team (AMRIC), the HSE national clinical programmes and the postgraduate training bodies for surgery, anaesthesia and obstetrics.

The primary drive for this initiative is to reduce the risk of patient harm from unnecessary doses of preventative antibiotics around the time of surgery.

Evidence shows that the majority of patients need just one dose of antibiotic to prevent surgical site infection but an Irish audit in September and October 2020 showed that prophylaxis exceeded a single dose in 62 per cent of patients. For comparison, a 2017 European study performed in Scotland demonstrated that only 35 per cent of patients received more than one dose of antibiotic for prophylaxis.

The position statement is intended to represent clear recommendations, supported by evidence and the broadest possible consensus of expert opinion in Ireland, regarding generally accepted maximum durations of surgical antibiotic prophylaxis for different types of surgery.

A collaborative working group including AMRIC and the NCPS have developed additional resources to support the implementation and launch of this programme. These resources include an audit tool, posters, a PowerPoint presentation and an eLearning module.  The eLearning module is available through HSeLanD and focusses on all aspects of surgical antibiotic prophylaxis including ‘the right duration’. The eLearning module can be used towards Irish Medical Council CPD requirements.

Prof Deborah McNamara, Co-Lead, NCPS, said: “Reducing the risk of surgical site infection is a priority for every surgeon. We welcome this guidance that will give surgeons and their teams, further tools to support best practice while also minimising patient harm and the development of antimicrobial resistance in Ireland.”

The position statement is available at the following link – Surgical Antibiotic Prophylaxis – HSE.ie

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