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Invited Critique |

Implementing 1-Dose Antibiotic Prophylaxis for Prevention of Surgical Site Infection—Invited Critique

Martin A. Makary, MD, MPH
Arch Surg. 2006;141(11):1114. doi:10.1001/archsurg.141.11.1114.
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Rates of SSI are emerging as the leading indicator of quality in surgery. The Center for Medicare & Medicaid Services recently announced its plan to use SSI rates to adjust payments (aka pay-for-performance). Attention on SSI as a surrogate of quality, combined with the growing problem of antibiotic-induced resistance, has brought the issue of prophylaxis to the center stage. This study of 12 299 elective surgical patients found that single-dose antibiotic prophylaxis resulted in the same incidence of SSI as 24-hour dosing and concluded that single-dose administration is equivalent, cheaper, and achievable at a high-volume center. Inherent in their findings is an advocacy for the judicious use of antibiotics—a timely message given a long history of overuse within our profession.

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