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Surgical site infection treatment antibiotic guidelines

Surgical Site Infection Guidelines Infection Control CD

Previous Guideline. Guideline for the Prevention of Surgical Site Infection (1999) Page last reviewed: November 5, 2015. Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP Antibiotic treatment of surgical site infection and treatment failure 1.4.9. When surgical site infection is suspected by the presence of cellulitis, either by a new infection or an infection caused by treatment failure, give the patient an antibiotic that covers the likely causative organisms

Surgical site infections - Diagnosis, treatment and

Surgical site infections: prevention and treatment - NCBI

  1. Guidelines on Antimicrobial Prophylaxis in Surgery, 1 as well as guidelines from IDSA and SIS.2,3 The guidelines are in-tended to provide practitioners with a standardized approach to the rational, safe, and effective use of antimicrobial agents for the prevention of surgical-site infections (SSIs) based o
  2. In April 2019 this guideline was updated. Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken i
  3. istered antibiotic prophylaxis reduces the incidence of surgical wound infection. Prophylaxis is uniformly recommended for all clean-conta
  4. Consensus Guideline on Preoperative Antibiotics and Surgical Site Infection in Breast Surgery Purpose . To outline recommendations for reducing and treating surgical site infections (SSIs). Associated ASBrS Guidelines or Quality Measures . 1. This document replaces the previous ASBrS Statement of Position Statement o
  5. Type of Infection Suspected Organisms Recommended Treatment Burn Wounds S. aureus, P. aeruginosa • Surgical debridement is essential for clinical cure • Topical antimicrobials may be beneficial, directed by Burn surgeons/Dermatology • Systemic prophylactic antibiotics are not routinely recommended outside of surgical site infection.

A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections Background: Previous evidence-based guidelines on the management of intra-abdominal infection (IAI) were published by the Surgical Infection Society (SIS) in 1992, 2002, and 2010. At the time the most recent guideline was released, the plan was to update the guideline every five years to ensure the timeliness and appropriateness of the recommendations Guidelines for the prevention, detection, and manage-ment of surgical site infections (SSI) have been published previously.1-3 This document is intended to update earlier guidelines based on the current literature and to provide a concise summary of relevant topics. Surgical site infections are both common and morbid. Surgical site infections. Infection Control & Hospital Epidemiology 2014; 35(06):605-627. Bratzler DW et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. American Journal of Health-System Pharmacy 2013; 70(3)195-283. Mangram AJ et al. Guideline for Prevention of Surgical Site Infection, 1999 Superficial Surgical Site Infections Infections involving the subcutaneous tissue within 30 days of operation For SSI involving deep tissue or organ space or complicated by sepsis/septic shock, see below or organ specific guidelines (Intra-abdominal, Gynecology, Meningitis, Endocarditis, Bone and Joint) Suture removal plus incision an

Video: Clinical Practice Guidelines for Antimicrobial Prophylaxis

Surgical Site Infection: Prevention and Treatment of

Current Guidelines for Antibiotic Prophylaxis of Surgical

NHSN Surgical Site Infection Surveillance in 2019 3. de Lissovoy, G., et al., Surgical site infection: Incidence and impact on hospital utilization and treatment costs. Am J Infect Contro l, 37(5): (2009): 38797. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection. JAMA Surg, 152(8. Antibiotic use for the urgent management of dental pain and intraoral swelling (ADA, published 2019) Intrapartum management of intraamniotic infection (ACOG, published 2017) Methicillin-resistant Staphylococcus aureus infections (IDSA, published 2011) Outpatient parenteral antimicrobial therapy guidelines (IDSA, published 2018 appropriate antibiotic prophylaxis for surgical patients. 3. To increase knowledge of the high burden of preventable SSI and to mobilize surgeons, nurses, technical support staff, anaesthetistsand any professionals directly providing surgical care. 4. Because every infection prevented is an antibiotic treatment avoided Guideline for the Prevention of Surgical Site Infection 2017: Background, Methods, and Evidence Summaries.) 2 GDFT refers to a hemodynamic treatment based on the titration of fluid and inotropic drugs according to cardiac output or similar parameters

When surgical site infection is suspected by the presence of cellulitis, either by a new infection or an infection caused by treatment failure, give the patient an antibiotic that covers the likely causative organisms. Consider local resistance patterns and the results of microbiological tests in choosing an antibiotic A surgical site infection is defined as an infection that occurs at or near a surgical incision within 30 days of the procedure or within one year if an implant is left in place.1, 2 The Centers. General principles for prevention of surgical site infection are discussed separately. (See Overview of control measures for prevention of surgical site infection in adults.) The epidemiology, clinical manifestations, diagnosis, and treatment of orthopedic hardware infections are discussed separately A stakeholder highlighted that the Global guidelines for the prevention of surgical site infections (World Health Organisation [WHO] 2016) recommends the following: 'The panel suggests that preoperative oral antibiotics combined with mechanical bowel preparation should be used to reduce the risk of SSI in adult patients undergoing elective colorectal surgery'

During the consultation period for this guideline, stakeholders raised the use of preoperative prophylactic antibiotics plus mechanical bowel preparation, to reduce surgical site infections in adults undergoing elective colorectal surgery The Asia Pacific Society of Infection Control (APSIC) launched the APSIC Guidelines for the Prevention of Surgical Site Infections in 2018. This document describes the guidelines and recommendations for the setting prevention of surgical site infections (SSIs). It aims to highlight practical recommendations in a concise format designed to assist healthcare facilities at Asia Pacific region in. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 1992; 326:281. van Kasteren ME, Manniën J, Ott A, et al. Antibiotic prophylaxis and the risk of surgical site infections following total hip arthroplasty: timely administration is the most important factor

Antibiotic prophylaxis for (Non Cardiac) Thoracic Surgery

the use of antibiotics for prophylaxis and treatment. However, antibiotic misuse for obstetric conditions or procedures that are guidelines into action at the country level. Readers are referred to the full recommendations for an understanding of the undergoing surgery to prevent surgical site infections before caesarean section Surgical Site Infection Surgical site infections are the second most common healthcare-associated infection. The CDC and the National Nosocomial Infection System have established criteria for defining SSIs that are widely used by SSI-surveillance and perioperative personnel.2 An SSI is an infection related to an operative procedure that occurs a Skin & Skin Structure Infections. Acute Bacterial Skin and Soft-Structure Infection Guidelines (ED & CDU) Surgical Antibiotic Prophylaxis Guidelines. --- Interventional Radiology Antibiotic Recommendations surgical procedure, for example joint or peritoneum. The drainage of pus or the formation of an abscess detected by histopathological or radiological examination or during re-operation. Horan TC, Gaynes RP, Martone WJ, et al. CDC definitions of nosocomial surgical site infections, 1992: a modification o CLINICAL EXAM FOR THE DIAGNOSIS OF SURGICAL SITE INFECTIONS Moderate strength evidence supports that clinical exam (i.e. pain, drainage, fever) is a moderate to strong rule-in test (i.e. high probability of presence of infection, if test is positive) for patients with suspected surgical site infections, but a weak rule- out test

ACS and SIS: American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update Prevention of Infection at the Surgical Site. Donald E. Fry Surgical Infections. May 2017, 18(4): 377-378. Citation. 2017: Surgical Perspective: Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection 2017. Selwyn O. Rogers Jr Surgical Infections. May 2017, 18(4): 383-384. Citation. 201 SURGICAL SITE INFECTIONS. Surgical site infections (SSIs) after cardiac surgery can present with a wide range of severity. Superficial sternal wound infections (SSWIs) complicate 0.5% to 8% of cardiac surgery cases and involve the skin, subcutaneous tissue, and pectoralis fascia. 5,6 Deep sternal wound infections (DSWIs) involve the sternal bone, the substernal space, and the mediastinum 7 but.

Practice Guidelines for the Diagnosis and Management of

[1-4]. Surgical site infections (SSIs) and particularly ster-nal and mediastinal infections have implications for significantly increasing both morbidity and mortality, as well as their associated costs in both man-hours and dollars spent [5, 6]. Part I of this evidence-based guideline series (Th Surgical & Medical Antimicrobial Prophylaxis - Pre-operative antibiotics can help prevent surgical site infections for surgical procedures at higher risk. The following antimicrobial prophylaxis guidelines have been developed and are regularly updated using our own resistance data specifically for UC Davis Medical Center in order to maximize.

Antibiotic treatment of surgical site infection and treatment failure. When surgical site infection is suspected by the presence of cellulitis, either by a new infection or an infection caused by treatment failure, give the patient an antibiotic that covers the likely causative organisms Appendix 23: Antimicrobial-coated sutures to decrease surgical site infections: a systematic review and meta-analysis Appendix 24: Effect of laminar airflow ventilation on surgical site infections: a systematic review and meta-analysis Appendix 25: Summary of the systematic review on surgical antibiotic prophylaxis prolongatio 23. Treatment • Incisional: open surgical wound, antibiotics for cellulitis or sepsis • Deep/Organ space: Source control, antibiotics for sepsis. 24. Management of Incisional surgical site infection • Removal of sutures with drainage of pus • Debridement and open wound care • delayed primary or secondary suture • 15% of. Necrotizing soft tissues infections are a true surgical emergency and timely definitive care is essential. The main components of treatment are goal directed resuscitation, broad-spectrum antibiotic therapy, and surgical debridement. Most patients are septic with signs of shock and thus will require admission to an intensive care unit

Likely need shorter treatment with adequate surgical intervention (7-10 days post-op) and longer for osteomyelitis. Change to an oral regimen when patient is stable. Reference: IDSA Guidelines: Clin Infect Dis 2004;39:885-910. Surgical Site Infections (SSI) TREATMENT . Infections following clean procedure The guidelines for the prevention, detection, and management of gastroenterological surgical site infections (SSIs) were published in Japanese by the Japan Society for Surgical Infection in 2018. This is a summary of these guidelines for medical professionals worldwide. We conducted a systematic review and comprehensive evaluation of the evidence for diagnosis and treatment of.

Guideline Surgical site infections: prevention and treatment 6 months to 5 years, 4 mg/kg (maximum 200 mg per dose) or 50 mg twice a day for 3 days. 6 years to 11 years, 4 mg/kg (maximum 200 mg per dose) or 100 mg twice a day for 3 days. 12 years to 15 years, 200 mg twice a day for 3 days When surgical site infection is suspected, either de novo or because of treatment failure, use an antibiotic that covers the likely causative organisms, taking into consideration local resistance patterns and the results of microbiological tests. If debridement is required, do not use chlorinated solutions, gauze, dextranomer, or enzymatic. surgical site infections. The Surgical Care Improvement Project Antibiotic Guidelines Guidelines for SCIP (Surgical Care Improvement Project) 1.1. Establish Surgical Site Infection prevention as a strategic priority . 1.2. Develop and implement business/strategic plan to secure institutional resources . 1.3

The previous guidelines also outlined a number of conditions for which a duration of therapy beyond 24 h was not believed to be necessary. In such patients, the primary goal of therapy is prophylaxis against a surgical site infection, as opposed to treatment of an established infection. These conditions include The optimum duration of intravenous antibiotics after removal of the infected prosthesis has not been established definitively and review of available reports reveals the duration of antibiotic therapy to be extremely variable. 11,14,29,38,77,81 Although general guidelines for the use of intravenous antibiotic therapy have emerged, there is no. Surgical site infection is estimated to occur in roughly 4% of general or vascular operations. Although the type of procedure is the main factor determining the risk of developing a surgical site infection, certain patient factors have been associated with increased risk, including diabetes mellitus, older age, obesity, smoking, heavy alcohol consumption, admission from a long-term care. Surgical antibiotic prophylaxis guidelines. Surgical antibiotic prophylaxis is an accepted part of surgical practice to prevent infections at the surgical site and optimise post-operative recovery. Sepsis Kills is a suite of resources for treatment of sepsis Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol . 1999 Apr. 20 (4):250-78; quiz 279-80

Use Prophylactic Antibiotics Appropriately. An estimated 40-60 percent of Surgical Site Infections (SSIs) are preventable with appropriate use of prophylactic antibiotics. Overuse, under use, improper timing, and misuse of antibiotics occurs in 25-50 percent of operations. A large number of hospitalized patients develop infections caused by. The literature on duration of antibiotic therapy in amputated DFI is sparse and consists mostly of expert opinions. 2, 7, 24, 25 Available original data mainly concern two questions. Firstly, prevention against surgical site infection 26 following major amputation, not specifically in DFI Antibiotic prophylaxis in the perioperative period is the standard of care for nearly all surgical procedures and routinely prescribed during solid organ transplantation (SOT). The primary goal of perioperative antibiotic prophylaxis is to minimize postoperative surgical site infections (SSIs). SSIs are a significant issue in SOT

The Surgical Infection Society Revised Guidelines on the

Surgical site infections Healthcare-associated infections (HAIs) are infections that occur while receiving health care. Patients with medical devices (central lines, urinary catheters, ventilators) or who undergo surgical procedures are at risk of acquiring HAIs. HAIs continue to be a tremendous issue today. Surgical site infections (SSIs) are the most common healthcare-associated infections. Postoperative surgical site infections remain a major source of illness and a less frequent cause of death in the surgical patient ().These infections number approximately 500,000 per year, among an estimated 27 million surgical procedures (), and account for approximately one quarter of the estimated 2 million nosocomial infections in the United States each year () Surgical site infections (SSI) arise from contamination of the surgical site in the period of time between incision and closure. According to the Centers for Disease Control (CDC), SSI are defined as infections occurring at the site of surgery within 30 d after surgery, or, within 1 year if an implant is placed and the infection appears to be. The pooled RR of surgical site infection with postoperative continuation of antibiotic prophylaxis versus its immediate discontinuation was 0·89 (95% CI 0·79-1·00), with low heterogeneity in effect size betwee • Sepsis and Septi c Shock: Antibiotics for Adult Patients at KEMH . Infection Prevention and Management (IPM) • Group A Streptococcus • Influenza Like Illness in Adults • Prevention of Surgical Site Infections • See IPM policy library for other guidelines (e.g. measles, CMV, aseptic technique) Obstetrics & Gynaecology

The guidelines seek to reduce surgical site infections, which occur due to a multitude of organisms, and while mupirocin is effective at its primary use, it offers limited therapeutic coverage. 18 March 2014; Rating : 4.5 / 5 based on 103 user ratings CLICK HERE TO GET THIS BOOK Microbiology for Surgical Infections. Microbiology for Surgical Infections: Diagnosis, Prognosis and Treatment explores current trends in etiology and antibiotic resistance of pathogens responsible for devastating and complex surgical infections

Surgical site infections (SSI) are a common complication after a cesarean section (C-section) and mainly responsible for increased maternal mortality and morbidity, dissatisfaction of patients, longer hospital stays as well as higher treatment costs. The aim of this study is to determine the incidence rate and risk factors of surgical site infections in women undergoing caesarean section at. Keywords: surgical site infection, surgical antibiotic prophylaxis, Finote Selam General Hospital, Ethiopia Introduction Hospital-acquired infections remain a major clinical problem that caused significant morbidity and mortality, and increased healthcare cost. 1 In developing countries, it is estimated that about 10% of hospitalized patients. In dermatologic surgery, prophylactic antibiotics are used to prevent either bacteremia or surgical site infection (SSI). Bacteremia can result in infective endocarditis (IE) and prosthetic joint infection (PJI) in vulnerable patients, and recently updated guidelines clearly stipulate when prophylactic antibiotics are to be used [1, 2].The use of antibiotics to prevent dermatologic surgical.

This evaluation will include determining the need for specialist wound care, debridement, pressure off-loading, or any other vascular or surgical interventions; reviewing the treatment of any infection (with antibiotic therapy based on guidelines established by each hospital); and assessing the need for interventions to prevent other foot. Background: health care-associated infection and surgical site infection The overall prevalence of health care-associated infection (HCAI) in England is 6·4% (confidence interval, 4·7-8·7%), with surgical site infections (SSIs) the third most commonly recorded infection (15·7%) (1). This is an underestimate, a Postoperative infection remains the most common complication of gynaecological surgical procedures. 1 A surgical site infection (SSI) is any infection that arises within 30 days after an operation in any part of the body where the surgery took place: superficial at the incision site, deep at the incision site or in other organs or spaces opened or manipulated during an operation. Surgical Site Infection: Prevention and Treatment of Surgical site infections: prevention and treatment (NG125) This guideline covers preventing and treating surgical site infections in adults, young people and children who are having a surgical procedure involving a cut through the skin conventional triple antibiotic prophylaxis in elective colorectal cancer surgery. J Korean Med Sci 2010;25:429-34. 7. Apanga S, Adda J, Issahaku M, Amofa J, Mawufemor KR, Bugr S. Post-operative surgical site infection in a surgical ward of a tertiary care hospital in Northern Ghana. Int J Res Health Sci 2014;2:207-12. 8

ACS and Surgical Infection Society Announce Guidelines for

Surgical site infection ! Prophylactic antibiotics ! Perioperative infection control KEY POINTS! Surgical site infections (SSIs) are the most common type of healthcare-associated infection in the United States, affecting more than 500,000 patients annually. Studies suggest that 40% to 60% of these infections may be preventable Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017 Aug 1. 152 (8):784-791. . . [Guideline] Ling ML, Apisarnthanarak A, Abbas A, Morikane K, Lee KY, Warrier A, et al. APSIC guidelines for the prevention of surgical site infections Published: 01/10/2008. Prevention and treatment of surgical site infection (NICE clinical guideline 74) The guideline makes recommendations for prevention and management of surgical site infections based on rigorous evaluation of the best available published evidence. This guideline was produced by the National Collaborating Centre for Women. WHO Surgical Site Infection Prevention Guidelines Web Appendix 4 Summary of a systematic review on screening for extended spectrum beta-lactamase and the impact on surgical antibiotic prophylaxis 1. Introduction the treatment of infections are now extremely limited due to the lack of developmen

1. J Obstet Gynaecol Res. 2018 Sep;44(9):1800-1807. doi: 10.1111/jog.13714. Epub 2018 Jul 26. Prevention of surgical site infection via antibiotic administration according to guidelines after gynecological surgery patient has a documented or suspected infection. In pancreatic transplantation, continuation of antibiotics until duodenal cultures result is an exception. Patients with existing infections The appropriate antibiotic to treat the underlying infection should be chosen on a case-by-case basis Continue the antibiotic to treat infection The Global Guidelines for the Prevention of Surgical Site Infection includes a list of 29 concrete recommendations distilled by 20 of the world's leading experts from 26 reviews of the latest evidence. The recommendations were also published today in The Lancet Infectious Diseases and are designed to address the increasing burden of health care associated infections on both patients and. Algorithm for the management and treatment of surgical site infections. *For patients with type 1 (anaphylaxis or hives) allergy to β-lactam antibiotics. Where the rate of infection with methicillin-resistant Staphylococcus aureus infection is high, consider vancomycin, daptomycin, or linezolid, pending results of culture and susceptibility tests

Barie, PS. Breaking with tradition: Evidence-based antibiotic prophylaxis of open fractures. Surgical Infections 2006;7:327-9 (Editorial accompanying above guideline) Penn-Barwell JG, Murray CK, Wenke JC. Early antibiotics and debridement independently reduce infection in an open fracture model. J Bone Joint Surg Br 2012;94-B:107- 11 Therapeutic antibiosis is used in the treatment of an infection and requires the prescription of a course that extends beyond clinical cure. Surgical site infections (SSIs) are defined as any infection occurring at the surgical site within 30 days, or 1 year if implants remain in situ. Therapy is based on identification and sensitivity testing.

If the cause of the infection is not found after 3 days, treatment should be guided by the clinical course. Once a reasonable period of antibiotic treatment has been completed, administration should be discontinued. Surgical site infections (SSIs) can be reduced with appropriate preparation • wound or surgical site infections; and Klebsiella infection can be treated with antibiotics. treatment as prescribed by the health care provider. If the health care provider prescribes an antibiotic, patients must take it exactly as instructed and complet

Guidelines for Treatment of Skin and Soft Tissue Infections . These guidelines are not intended to replace clinical judgment. The antimicrobials are not listed in order of preference, and therapeutic decisions should be based on a number of factors including patient history antibiotics did not prevent infection. Forrester et al. performed a systematic literature review for the Surgical Infection Society (SIS) Guidelines for Antibiotic Use in Patients with Traumatic Facial Fractures (7). This group identified 3 trials for the subgroup of nonoperative midface, upper face, or mandibular facial fractures According to the 2017 CDC guideline for the prevention of surgical site infection, administration of post-operative antibiotic doses is not recommended in clean and clean-contaminated procedures. PROCEDURE 1. Documentation of antimicrobial administration must include date, time o Doctors call these infections surgical site infections (SSIs) because they occur on the part of the body where the surgery took place. If you have surgery, the chances of developing an SSI are about 1% to 3%. Types of surgical site infections. An SSI typically occurs within 30 days after surgery. The CDC describes 3 types of surgical site. Don't routinely use topical antibiotics on a surgical wound. Any possible reduction in the rate of infection from the use of topical antibiotics on clean surgical wounds compared to the use of non-antibiotic ointment or no ointment is quite small. Risk reduction may be overshadowed by the risks of wound irritation or contact dermatitis

3. In cardiac surgeries where surveillance data show MSSA as a cause of surgical-site infections despite cefazolin prophylaxis, cefuroxime may be considered as an alternative. 4. Ceftriaxone + Metronidazole is the preferred treatment for community-acquired intra-abdominal infection. Refer to the SHC Disease State Guidelines for more information. 5 Treatment. The treatment of retroperitoneal infections consists of the control of infection source, use of antibiotic agents, and nutritional support. Timely and effective control of the source of infection is the most crucial, aiming to remove the infected suppurative and necrotic tissue Global guidelines on the prevention of surgical site infection (2016) WHO guidelines for safe surgery 2009 - safe surgery saves lives. US Centers for Disease Control and Prevention (CDC) Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection (2017) US Centers for Disease Control and Prevention (CDC The prevention of surgical site infections (SSIs) remains a major focus of attention due to the increased risks of morbidity and mortality, and large economic costs [1, 2].In the United States, SSIs are considered the second most common healthcare-associated infection and occur as a serious complication of an estimated 300 000-500 000 surgical procedures each year [3, 4] Surgical site infections (SSI) are a common complication after a cesarean section (C-section) and mainly responsible for increased maternal mortality and morbidity, dissatisfaction of patients, longer hospital stays as well as higher treatment costs. clinical practice guidelines for antibiotic prophylaxis in obstetric procedures does not.

If the infection is caught early, your doctor may prescribe intravenous (IV) or oral antibiotics. This treatment has a good success rate for early superficial infections. Surgical Treatment. Infections that go beyond the superficial tissues and gain deep access to the artificial joint almost always require surgical treatment. Debridement Guidelines to aid providers in the proper use of prophylactic antibiotics exist for adults, but are rare in the neonatal surgical population. A recent emphasis on appropriate antibiotic stewardship had led to the development of more guidelines without a coincident increase in surgical site infection. Robust data from randomized, controlled.

Surgical Site Infection | SymposiumASK DIS: Management of Skin and Soft Tissue Infections

Mangram, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999 Apr;20(4):250-78. Anderson, et al. Strategies to Prevent Surgical Site Infections in Acute Care Hospitals. Infect Control Hosp Epidemiol 2008;29:S51-S61 Hernandez OG, Castaneda NJ. Prevention of infections. A look at the new Global guide to surgical site infection prevention. Acta Pediatr Mex. 2017;38(1):1-9. Davide PV, Bruno A, Di Trapani B, et al. 2016 WHO global guidelines for the prevention of surgical site infection: a new step to improve patient´s safety before, during and after surgery Surgical-site infections (SSIs) should be managed with a combination of surgical care and antibiotic therapy. Antibiotic coverage should be modified once culture results are available. Severe infections such as streptococcal gangrene and extensive tissue necrosis need aggressive surgical intervention