29 steps to avoid infection, superbugs

People preparing for surgery should always have a bath or shower but not be shaved, and antibiotics should only be used to prevent infections before and during surgery, not afterwards, say the new guidelines from the World Health Organisation that aim to save lives, cut costs and arrest the spread of superbugs.

The guidelines include 29 concrete recommendations distilled by 20 of the world’s leading experts from 26 reviews of the latest evidence. "No one should get sick while seeking or receiving care," said Marie-Paule Kieny, WHO’s Assistant Director-General for Health Systems and Innovation.

Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11per cent of patients who undergo surgery are infected in the process. In Africa, up to 20 per cent of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies.

Surgical site infections in the US contribute to patients spending more than 400 000 extra days in hospital at an additional cost of $900 million per year.

No international evidence-based guidelines had previously been available and there are inconsistencies in the interpretation of evidence and recommendations in existing national guidelines.

The guidelines range from the best way for surgical teams to clean their hands, to guidance on when to use antibiotics to prevent infections, what disinfectants to use before incision, and which sutures to use.

Antibiotics are used to prevent and treat bacterial infections. But resistance to it occurs when bacteria change in response to the use/misuse of these medicines.

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