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Antimicrobial prophylaxis for prevention of surgical site infection in adults

Deverick J Anderson, MD, MPH
Daniel J Sexton, MD
Section Editor
Anthony Harris, MD, MPH
Deputy Editor
Elinor L Baron, MD, DTMH


Surgical site infections (SSIs) are a common cause of healthcare-associated infection. The United States Centers for Disease Control and Prevention (CDC) has developed criteria that define surgical site infection as infection related to an operative procedure that occurs at or near the surgical incision within 30 days of the procedure or within 90 days if prosthetic material is implanted at surgery [1]. SSIs are often localized to the incision site but can also extend into deeper adjacent structures. (See 'Definitions' below.)

Among surgical patients, SSIs are the most common nosocomial infection, accounting for 38 percent of nosocomial infections. It is estimated that SSIs develop in 2 to 5 percent of the more than 30 million patients undergoing surgical procedures each year (ie, 1 in 24 patients who undergo inpatient surgery in the United States has a postoperative SSI) [2,3].

Antimicrobial prophylaxis for prevention of SSI will be reviewed here. Issues related to epidemiology and adjunctive measures for prevention of SSI are discussed separately. (See "Adjunctive measures for prevention of surgical site infection in adults" and "Epidemiology of surgical site infection in adults".)


The United States Centers for Disease Control and Prevention (CDC) has developed criteria which define surgical site infection (SSI) as infection related to an operative procedure that occurs at or near the surgical incision (incisional or organ/space) within 30 days of the procedure or within 90 days if prosthetic material is implanted at surgery. These criteria have become the national standard and are widely used by surveillance and surgical personnel [2,4,5].

Clinical criteria for defining SSI include one or more of the following [6,7]:


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