Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492007000400012
Jornal Vascular Brasileiro
Original Article

Profilaxia antimicrobiana em cirurgia vascular periférica: cefalosporina ainda é o padrão-ouro?

Antimicrobial prophylaxis in peripheral vascular surgery: is cephalosporin still the gold standard?

Eduardo Lichtenfels; Márcio L. Lucas; Ronaldo Webster; Pedro A. d' Azevedo

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Resumo

Nas cirurgias vasculares periféricas, as cefalosporinas têm seu uso consagrado como agente antimicrobiano profilático de escolha. Recentemente, observamos uma mudança nos padrões de colonização, prevalência de patógenos e suscetibilidade geral aos antimicrobianos. Os patógenos multirresistentes vêm se tornando cada vez mais freqüentes nas infecções de ferida cirúrgica vascular, demonstrando variações regionais e locais quanto à suscetibilidade aos antimicrobianos profiláticos utilizados na rotina cirúrgica. Os dados e a literatura disponível até o momento demonstram que não existe evidência suficiente para uma mudança na rotina profilática perioperatória. Entretanto, devemos levar em consideração os padrões regionais e institucionais de prevalência de patógenos resistentes e padrões de suscetibilidade aos antimicrobianos para estabelecer guias e orientações específicas para a utilização de antimicrobianos profiláticos alternativos.

Palavras-chave

Antibioticoprofilaxia, infecção da ferida operatória, procedimentos cirúrgicos vasculares, cirurgia

Abstract

In peripheral vascular surgery, cephalosporins are nowadays regarded as the first choice for operative antibiotic prophylaxis. We have recently observed changes in colonizing patterns, pathogen prevalence and antibiotic susceptibility to antimicrobials. Multiresistant pathogens are becoming more frequent in vascular surgical wound infections, showing regional and local variations as to prophylactic antibiotic susceptibility. Data from the available literature so far have shown no strong evidence for a change in routine surgical antibiotic prophylaxis. We must consider regional and institutional prevalence of pathogen resistance and patterns of antibiotic susceptibility to establish specific guidelines for the use of alternative antibiotics.

Keywords

Antibiotic prophylaxis, surgical wound infection, vascular surgical procedures, surgery

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