Administration of antibiotic prophylaxis more than 120 minutes before incision or after incision is associated a higher risk of surgical site infections than administration less than 120 minutes before incision .
Abstract The aim of the study was to assess the effect of timing of preoperative surgical antibiotic prophylaxis ( SAP ) on  surgical site infection ( SSI )  and compare the different timing intervals .
The benefit of routine use of SAP prior to surgery has long been recognized .
However , the optimal timing has not been defined .
Evaluating the optimal timing of surgical antimicrobial prophylaxis: study protocol for a randomized controlled trial
Background Surgical site infections are the most common hospital-acquired infections among surgical patients . The administration of surgical antimicrobial prophylaxis reduces the risk of surgical site infections . The optimal timing of this procedure is still a matter of debate . While most studies suggest that it should be given as close to the incision time as possible , others conclude that this may be too late for optimal prevention of surgical site infections . A large observational study suggests that surgical antimicrobial prophylaxis should be administered 74 to 30 minutes before surgery . The aim of this article is to report the design and protocol of a r and omized controlled trial investigating the optimal timing of surgical antimicrobial prophylaxis . Methods / Design In this bi-center r and omized controlled trial conducted at two tertiary referral centers in Switzerl and , we plan to include 5,000 patients undergoing general , oncologic , vascular and orthopedic trauma procedures . Patients are r and omized in a 1:1 ratio into two groups : one receiving surgical antimicrobial prophylaxis in the anesthesia room ( 75 to 30 minutes before incision ) and the other receiving surgical antimicrobial prophylaxis in the operating room ( less than 30 minutes before incision ) . We expect a significantly lower rate of surgical site infections with surgical antimicrobial prophylaxis administered more than 30 minutes before the scheduled incision . The primary outcome is the occurrence of surgical site infections during a 30-day follow-up period ( one year with an implant in place ) . When assuming a 5 % surgical site infection risk with administration of surgical antimicrobial prophylaxis in the operating room , the planned sample size has an 80 % power to detect a relative risk reduction for surgical site infections of 33 % when administering surgical antimicrobial prophylaxis in the anesthesia room ( with a two-sided type I error of 5 % ) . We expect the study to be completed within three years . Discussion The results of this r and omized controlled trial will have an important impact on current international guidelines for infection control strategies in the hospital . Moreover , the results of this r and omized controlled trial are of significant interest for patient safety and healthcare economics . Trial registration This trial is registered on Clinical Trials.gov under the identifier NCT01790529
Administration of antibiotic prophylaxis more than 120 minutes before incision or after incision is associated a higher risk of surgical site infections than administration less than 120 minutes before incision .
Abstract The aim of the study was to assess the effect of timing of preoperative surgical antibiotic prophylaxis ( SAP ) on  surgical site infection ( SSI )  and compare the different timing intervals .
The benefit of routine use of SAP prior to surgery has long been recognized .
However , the optimal timing has not been defined .