What is the role of stewardship in relation to surgical prophylaxis?

The role of stewardship in relation to surgical prophylaxis is to recommend appropriate antibiotic use prior to surgery, with an emphasis on minimizing overuse and the risk of developing antibiotic resistance. This approach is essential because the goal of surgical prophylaxis is to prevent surgical site infections (SSIs), which can occur in the postoperative period.

By carefully selecting the most appropriate antibiotic based on factors such as the type of surgery, the patient's individual risk factors, and local susceptibility patterns of pathogens, the stewardship program ensures that antibiotics are used effectively and judiciously. This reduces the likelihood of unnecessary exposure to antibiotics, which can lead to resistance—a significant public health concern.

In contrast to this answer, advocating for longer courses of antibiotics after surgery or increasing the variety of antibiotics used does not align with the principles of stewardship that aim to reduce inappropriate use and promote the use of the most effective agents only as needed. Additionally, discouraging any antibiotic use in surgical patients overlooks the critical need for prophylaxis in preventing infections, which is necessary for optimal surgical outcomes. Stewardship programs are focused on balancing effective infection prevention with the need to mitigate the risk of developing resistance tendencies within bacterial populations.