Antibiotics

Question 1

If used prophylactically, antibiotics need to be in the tissue before the time of wounding and contamination (ie. there must be a pre-operative dose).

Answer 1

T

Question 2

The most frequently isolated pathogens causing surgical site infections are S.aureus, coagulase-negative Staph, Enterococcus spp., and Propionbacterium acnes.

Answer 2

T

Question 3

Tobacco and alcohol use are not risk factors for the development of surgical site infections.

Answer 3

F

Question 4

Higher rates of surgical site infections are associated with procedures below the knee, wedge excisions of the lip or ear, skin grafts, and lesions in the groin.

Answer 4

T

Question 5

Patients on warfarin and/or aspirin tend to have higher rates of surgical site infection.

Answer 5

F

Question 6

Diabetes mellitus is a risk factor that has been associated with defects in the leukocyte mobilization

Answer 6

T

Question 7

Patients with well-controlled diabetes mellitus still have increased infection rates compared with people who do not have diabetes mellitus.

Answer 7

F

Question 8

Treating nasal carriage of S.aureus may reduce the risk of surgical site infection.

Answer 8

T

Question 9

HIV infection itself predisposes to surgical site infection.

Answer 9

F

Question 10

Shaving of hair the night before an operation is associated with lower rates of surgical site infection.

Answer 10

F Clipping hair immediately before the procedure is better, or don’t clip at all.

Question 11

Antibiotics should be given prophylactically in all cases of Class II (clean-contaminated) wounds, eg. wounds in oral cavity, respiratory tract, axilla/perineum.

Answer 11

F Class III and IV only.

Question 12

If it is necessary to give antibiotic prophylaxis, only a single preoperative dose is recommended.

Answer 12

T

Question 13

Wound infection of wounds healing by secondary intention is rare if the wounds are properly cared for.

Answer 13

T

Question 14

The overall rate of infection is low but in procedures in the groin, skin grafts, ledge excisions of the lip or ear, and procedures below the knee the rate of infection reaches >2%

Answer 14

F >5%

Question 15

Topical antibiotics should be used for all dermatological surgery wounds.

Answer 15

F Only Class III and IV wounds.

Question 16

Facial laser resurfacing is considered a class II clean-contaminated type wound which does not require prophylactic antibiotics.

Answer 16

T

Question 17

Post-operative surgical site infections usually present between post-operative days 2-4.

Answer 17

F 4-10.

Question 18

Endocarditis prophylaxis is required in all patients with a prior history of infective endocarditis.

Answer 18

T

Question 19

Endocarditis prophylaxis is required in all patients who have ever had a repair of a congenital heart defect.

Answer 19

F Only within the first 6 months after the procedure, or if residual defects.

Question 20

Endocarditis prophylaxis is required in all patients with a prosthetic heart valve.

Answer 20

T

Question 21

Antibiotic prophylaxis is required in all patients who have had a joint replacement in the last 5 years.

Answer 21

F 2 years.

Question 22

Antibiotic prophylaxis is required in all patients with a prior history of prosthetic joint infection.

Answer 22

T

Question 23

Antibiotic prophylaxis is required in all patients with a joint replacement who have type I diabetes, HIV, malignancy or malnourishment.

Answer 23

T

Question 24

Antibiotic prophylaxis is recommended for all patients who have cardiac pacemakers or internal defibrillators.

Answer 24

F

Question 25

Haematomas are associated with the development of postoperative wound infection.

Answer 25

T

Question 26

cephalexin 500mg QID starting from the time of surgery is considered an appropriate choice of prophylactic antibiotics in high risk patient groups

Answer 26

F - 1-2g PO stat cephalexin Q1H prior to surgery OR 2g amoxicillin PO stat dose

Question 27

routine prophylactic antibiotics are recommended in ablative laser resurfacing

Answer 27

F

Question 28

ears + nose procedures have higher rates of SIS

Answer 28

T