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A number of bacterial and viral diseases are self-limiting and do not benefit from antibiotics. Prescribing of antimicrobial therapy in such cases may expose the patient to undue risks and may contribute to the development of resistance.
These factors should be considered in light of the clinical condition of the patient.
The aim of prophylaxis in the surgical setting is to produce adequate tissue and plasma levels at the time contamination is most likely which is during the procedure.
Empirical antimicrobial therapy should be prescribed based on likely clinical diagnosis, suspected aetiology and local susceptibility test results. Where possible, such information has been incorporated into these guidelines. It is important, where possible, to:
Review of empirical antimicrobial prescribing should be made in light of available culture results. This information, considered in the context of the clinical condition of the patient, should be used to prescribe the most efficacious, cost-effective agent with the lowest incidence of toxicity and the narrowest spectrum of activity. Such practice will help to reduce the problems associated with broad-spectrum therapy i.e. selection of resistant microorganisms and superinfection.
Change from intravenous to oral therapy as soon as possible.